| NPI | 1609096106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON T. AUSTIN President 770-832-7374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA 8598) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |