| NPI | 1538665963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON MICHAEL HOWARD Owner 770-624-0029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA 14143) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 14985) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |