| NPI | 1528239548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHAIM KALANTAROV President 770-993-9048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 012445) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |