| NPI | 1699889857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGEY GRITSIV President 770-534-4292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013149) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |