| NPI | 1205219672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIYUSH PATEL Omfs 770-559-3648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: GA 11772) |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2015-08-07 |