| 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 |