| NPI | 1619313384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN BUCKLE Dentist 678-982-5130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA dn014232) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |