NPI | 1316160245 |
---|---|
Former Legal Business Name | WISE FAMILY COSMETIC DENTISTRY, P.C. |
Entity Type | Organization |
Authorized Contact | LISA D. JONES CFO 770-387-1277 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013063) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2008-10-06 |