| NPI | 1619477460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMIESH CRANE Owner 770-981-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |