NPI | 1437568805 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELLE CHUNG Manager 770-598-5082 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: HI DT-2478) |
Enumeration Date | 2014-08-10 |
Last Update Date | 2014-08-10 |