| NPI | 1548852767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH A HUMPHREYS Owner 770-328-9963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2021-04-07 |