| NPI | 1356734115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN CHONG Owner 404-512-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN014085) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2015-03-17 |