| NPI | 1407982119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS WATSON President 770-941-6979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012720) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |