NPI | 1417027939 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT E STANSELL President 770-867-2277 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 10705) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 9836) |
Enumeration Date | 2006-11-09 |
Last Update Date | 2020-08-22 |