| NPI | 1245671353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREAL C BINGHAM CLAY Office Coordinator 770-475-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN013090) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |