NPI | 1235354895 |
---|---|
Entity Type | Organization |
Authorized Contact | CANDACE H. RAUSCH Secretary Treasurer 770-931-3388 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 9829) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 9656) |
Enumeration Date | 2007-04-17 |
Last Update Date | 2009-07-13 |