| NPI | 1609162460 |
|---|---|
| Doing Business As | PINE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MICHELLE JACOMINO Director Of Payor Relations 770-916-5036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2024-01-18 |