| NPI | 1659581163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY PULLEY Office Manager 770-495-9575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 11075) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |