| NPI | 1134342090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SLOCUM Dentist 770-387-9249 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 11266) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 11289) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2008-07-14 |