| NPI | 1184760753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN RITTGERS Office Manager 678-417-7709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA 13018) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA 12813) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2008-05-22 |