| NPI | 1619138666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID VIETH Owner 770-916-5028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| 1223E0200X Dentist, Endodontics | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2014-12-17 |