| 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 |