| NPI | 1467510180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA PARIS VANSANT Office Manager 770-475-4449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 010150) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 010463) |
| 1223G0001X Dentist, General Practice (Licence: GA 010314) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |