| NPI | 1467634741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETHE TRALONGO Owner 404-537-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 0011999) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2017-12-29 |