| NPI | 1679969380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMER MUFID OTHMAN Owner 478-207-6939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN014686) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2015-04-09 |