| NPI | 1124561022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHANT NATH Dentist 770-651-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013057) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2016-11-23 |