| NPI | 1285736801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C. SIEWEKE President 770-786-2754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 9102) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2020-08-22 |