| NPI | 1629380191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY MORGAN Owner 770-591-7929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 10504) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 014049) |
| 1223G0001X Dentist, General Practice (Licence: GA 011800) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |