| NPI | 1316580046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA J HARP Director, Revenue Cycle Operations 678-372-7358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2020-07-30 |