NPI | 1710003488 |
---|---|
Entity Type | Organization |
Authorized Contact | BRUCE ALAN HESTER President 770-422-1554 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 11090) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2020-08-22 |