| NPI | 1558768770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNDI SIMMONS Practice Manager 770-466-0474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA GA8776) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |