| NPI | 1205919461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI SHURDEN MOSCATTINI Office Mgr 770-476-4144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 11526) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2008-06-17 |