| NPI | 1275981003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A SNOW Credentialing 404-410-1340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2017-05-10 |