| NPI | 1609882430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN D. ANDERSON Dentist 770-384-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012777) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |