NPI | 1700058302 |
---|---|
Other Name | CANTON OFFICE |
Entity Type | Organization |
Authorized Contact | RICHARDSON MICHAEL ODUM President 678-493-6693 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: GA 10232, 10416) |
Enumeration Date | 2008-03-24 |
Last Update Date | 2008-03-24 |