| NPI | 1518030089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C JAGOR CEO 404-256-2551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN009744) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN005683) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |