| NPI | 1760142970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH EDWARD STARLING Owner 770-846-8948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2021-12-29 |