| NPI | 1417961152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JACK MAHAFFEY Doctor 770-487-6439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 12464) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |