| NPI | 1225732472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER TOMLINSON Credentialing Specialist 404-410-1340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-03-29 |