| NPI | 1376288209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS FIEGLE President 404-295-5811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-05-04 |