| NPI | 1619297025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL REZNIK Owner 770-777-7427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2010-06-08 |