| NPI | 1629442074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL S KWON Owner 678-714-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012637) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2015-12-02 |