| NPI | 1215108220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM H. WALL Dentist 770-448-0966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN006817) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |