| NPI | 1356580633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON NEIL BONGIOVI President 404-316-0588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN013085) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-02-11 |