| NPI | 1356463145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN LEE DURHAM President 770-227-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 9416) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |