| NPI | 1700126398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA MAGUIRE Office Manager 770-480-3751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012444) |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2013-02-19 |