| NPI | 1689960692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARRETT L MANNING Owner 678-640-5272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013349) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-06-28 |