| NPI | 1164826897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN PETERS Owner/Dentist 404-233-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012879) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN014161) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN014377) | |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-09 |