| NPI | 1194972901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIELLA RAMOS Office Manager 678-714-7011 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012082) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013443) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN008032) | |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2008-08-22 |