| NPI | 1235653031 |
|---|---|
| Doing Business As | FOUNTAIN INN DENTAL |
| Entity Type | Organization |
| Authorized Contact | VIKAS R. JAIN Owner 706-877-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2022-07-21 |