| NPI | 1518824937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN ALBERT BRUNSON Dentist/ CEO 770-230-0222 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2026-01-07 |
| Last Update Date | 2026-01-07 |