| NPI | 1164815254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDA GORDON CEO/ Dentist 404-349-7730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: GA 1501026531) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |