| NPI | 1790196467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAGE PHELPS BARDEN Pres/CEO 404-272-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: GA DN0010757) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-05-15 |