| NPI | 1407061286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JEFFREY KINCAID Doctor 770-516-5773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN010224) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |