| NPI | 1245676907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CORY RYAN President 404-694-2584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 00201797) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |