| NPI | 1427462720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA DUONG Office Manager 770-609-6106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |