| NPI | 1417809138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MATTHEW DUNFORD Owner 678-200-4922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2026-02-13 |
| Last Update Date | 2026-06-26 |