| NPI | 1114425964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIANA HOUSTON CFO 404-384-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: GA DN014207) |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2018-01-26 |