| NPI | 1306952122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISA M NELSON President / Dentist 678-377-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012336) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2012-12-11 |