NPI | 1255524120 |
---|---|
Doing Business As | PINE DENTISTRY |
Entity Type | Organization |
Authorized Contact | MICHELLE JACOMINO Director Of Payor Relations 770-916-5036 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401411091) |
1223E0200X Dentist, Endodontics | |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
Enumeration Date | 2007-08-23 |
Last Update Date | 2024-01-18 |