| NPI | 1629190335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY CHARLES BELL Dentist 770-909-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 1223G0001X) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |