| NPI | 1457504573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIA P. URREGO President 770-534-6933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN013677) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2008-11-03 |