| NPI | 1356485098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD ROBERT CORRELL Owner 770-981-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 7828) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2015-05-26 |