| NPI | 1518116896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN MOORE Owner 770-487-8896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012708) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |