| NPI | 1649806415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HECTOR M BUSH Owner 404-309-3226 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |