| NPI | 1730635400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTAKIA PRINCESS DANCE Owner 678-234-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA LPC009109) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |