| NPI | 1528195195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY K MARCUM Dentist 770-486-0054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 11234) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 12275) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |