| NPI | 1205296001 | 
|---|---|
| Doing Business As | AEON MEDICAL AND DENTAL COMMUNITY CLINIC | 
| Entity Type | Organization | 
| Authorized Contact | PHYLLIS ROSHAN President & CEO 770-876-3954 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Enumeration Date | 2016-03-07 | 
| Last Update Date | 2016-03-07 |