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 |