| NPI | 1558612465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE WITKIN Owner 770-536-3254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN009491) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2012-10-02 |