| NPI | 1437694791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W TAYLOR DOMINY Owner 770-631-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: GA DN010888) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |