| NPI | 1538420591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNY Y LIM Officer 770-382-1516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA 20211364798) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2013-03-14 |