| NPI | 1679029219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SENGSOURIYA ANANTHASANE Dentist 770-888-8295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN012307) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |