| NPI | 1285077933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHA YAMINI PONUGOTI Owner 678-613-5095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013843) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2013-04-12 |