| NPI | 1609230143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHANT NATH Owner 770-648-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN013057) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2016-04-11 |