| NPI | 1144506023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANG HUYNH President 678-412-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: GA 64391) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN012723) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: GA 64391) | |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2013-05-14 |