NPI | 1366710717 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES COULTER Owner 404-389-1950 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2011-12-13 |
Last Update Date | 2011-12-13 |