| NPI | 1144988957 |
|---|---|
| Doing Business As | SOUTHGLENN DENTAL CARE, PC |
| Entity Type | Organization |
| Authorized Contact | ANGELA EISWERTH Credentialing Manager 770-833-0994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2021-12-07 |