| NPI | 1396621363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORRY TAUBER Owner 770-720-8138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-08-14 |