| NPI | 1720395924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENISE A EVANS Dentist 404-622-0622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012623) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-09 |