| 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 |