| NPI | 1164816740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA RENEE MOORE Periodontist 404-445-9282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: GA DNCS000275) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |