| NPI | 1194746610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA TOMASELLI Owner 770-924-0424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 11182) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |