| NPI | 1295465367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINA KATCHOOI Owner 478-390-1960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-06-13 |