NPI | 1427519081 |
---|---|
Entity Type | Organization |
Authorized Contact | GINA S JACKSON Contracts, Cred & Benefits Mgr 770-446-8000 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
1223E0200X Dentist, Endodontics | |
1223P0700X Dentist, Prosthodontics | |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
Enumeration Date | 2019-03-27 |
Last Update Date | 2019-03-28 |