| NPI | 1205014578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S LYLE ZUCK President 770-995-7960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN013444) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2008-02-08 |