NPI | 1750055182 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN SMITH CEO 770-231-5348 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
1223P0221X Dentist, Pediatric Dentistry | |
Enumeration Date | 2021-08-09 |
Last Update Date | 2021-08-09 |