| NPI | 1760646053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL E FERMAN Dentist 770-251-6676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 8855) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2008-07-15 |