| NPI | 1679789200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC DAVID ANDERSON President 678-417-9656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 10755) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |