| NPI | 1477745263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN JAMES EDWARDS President 678-455-3734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012585) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |