| NPI | 1386762037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL PROCTOR President 770-483-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: GA 1164) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |