| NPI | 1710131545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA O. COLEMAN President 404-523-3153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA DN010307) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN013127) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2008-11-06 |