| NPI | 1295263481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI ROLLS Business Manager 404-452-1164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2022-07-21 |