| NPI | 1780101659 |
|---|---|
| Doing Business As | DBA FOUNTAIN VIEW DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | LAURA C. KOCH Owner 678-428-4058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |