| NPI | 1467277228 |
|---|---|
| Doing Business As | PROVIDENCE DENTAL SPA OF EAST COBB |
| Entity Type | Organization |
| Authorized Contact | HEATHER TAYLOR Director 470-309-8888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |