| NPI | 1669130498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDUL JABBAR KHAN Dentist/Owner 470-272-4607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2026-09-29 |