| NPI | 1467649319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D. BLANCHARD Owner 770-631-7001 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-09-25 |