| NPI | 1316959547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE BRIAN EVANS President 770-962-9560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 9789) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2020-08-22 |