| NPI | 1205608734 |
|---|---|
| Doing Business As | SANDY SPRINGS DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICAJAH J VICKERS Member 404-432-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2023-10-27 |