| NPI | 1215005376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNI TOMLINSON Credentialing Specialist 770-382-3536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2023-10-09 |