| NPI | 1255762563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R. LONG Owner 770-461-9642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 8203) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |