| NPI | 1699819938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE WHEELER Insurance Coordinator 770-496-0496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 7904) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-08-22 |