| NPI | 1427801042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN LEARY Practice Manager 770-723-9965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |