| NPI | 1376843078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIMISHA PATEL Dentist 770-271-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: GA DN013402) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |