| NPI | 1538255971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER A GRAGE President 404-289-6454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 6216) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |