| NPI | 1770754772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAMEUN NANCY KIL Doctor/Business Owner 770-497-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DNO12595) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DNO12519) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2019-06-14 |