| NPI | 1164645792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY DAVID COHEN President 770-394-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 9914) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |