| NPI | 1346312071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ANN WEBSTER Office Manager 770-418-1929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: GA 9120) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |