NPI | 1528639754 |
---|---|
Entity Type | Organization |
Authorized Contact | MONICA PERKINS Onboarding Specialist 678-244-4844 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2021-07-08 |
Last Update Date | 2022-09-12 |