| NPI | 1558446435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARTER SIDNEY ROSE President 770-993-0265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 7632) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |