| NPI | 1497263909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE THOMPSON Front Office 770-535-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013552) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |