| NPI | 1275810129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BLAIR Owner/Operator 404-324-2012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN011481) |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2014-09-28 |