| NPI | 1265503940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY NGUYEN President Dentist 770-431-9578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN011814) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 44962) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |