| NPI | 1699945311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ANTHONY JOHNSON President 770-475-3361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: GA DN0007750) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: GA DN007750) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-07-09 |