NPI | 1477200137 |
---|---|
Doing Business As | KENNESAW MODERN DENTISTRY |
Entity Type | Organization |
Authorized Contact | MICHELLE HOUSTON Owner 678-832-0527 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2022-03-03 |
Last Update Date | 2022-04-26 |