NPI | 1427110402 |
---|---|
Entity Type | Organization |
Authorized Contact | PAUL WILLIAM KING President CEO 770-952-1777 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: GA DN006968) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN007445) |
122300000X Dentist (Licence: GA DN007477) | |
Enumeration Date | 2006-12-15 |
Last Update Date | 2020-08-22 |