| NPI | 1568580017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS RUSSELL BROWN President 770-482-2964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA 7405) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2012-03-21 |