| NPI | 1639769201 |
|---|---|
| Doing Business As | COLONY SQUARE DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN CUTLER Secretary 404-482-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics | |
| 1223P0300X Dentist, Periodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2022-05-12 |