| NPI | 1588872436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOOF ALONZO BOONE Owner 478-746-7686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 6203) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2011-10-25 |