| NPI | 1497086367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GORLOVSKY Owner 770-888-1929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN013818) |
| Enumeration Date | 2010-01-16 |
| Last Update Date | 2010-01-16 |