| NPI | 1598173049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE REYNAUD KING Managing Member 404-233-1972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |