| NPI | 1437487550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANA LVOVNA MAMUT Owner Dentist 404-579-0519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: GA DN012943) |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2013-07-29 |