NPI | 1275625519 |
---|---|
Former Legal Business Name | BROOKS & MADDOX FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | ROBERT S BROOKS President 678-583-0330 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2006-09-28 |
Last Update Date | 2016-05-24 |