| NPI | 1275907891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY DILLON Dentist 770-435-6888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2016-03-09 |