| NPI | 1487701173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA J. RAWDIN Insurance Coordinator 770-227-9693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 010457) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |