| NPI | 1194238386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA HARP Director Of Insurance Operations 678-372-7358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN20996) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |