NPI | 1396900239 |
---|---|
Entity Type | Organization |
Authorized Contact | ELIZABETH SLOCUM Dentist 770-387-0750 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 11289) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 11266) |
Enumeration Date | 2008-07-21 |
Last Update Date | 2008-07-21 |