| NPI | 1710435763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATLYNN PITTMAN Office Manager 770-995-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014749) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN14715) |
| 122300000X Dentist (Licence: GA DN014749) | |
| 124Q00000X Dental Hygienist (Licence: GA DH003931) | |
| 124Q00000X Dental Hygienist (Licence: GA DH005357) | |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2016-09-20 |