| NPI | 1770023830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEMMIE TODD COX Owner/Dentist 770-486-9400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA DN011313) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2019-05-20 |