| NPI | 1790275253 |
|---|---|
| Doing Business As | CPACS COSMO DENTAL |
| Entity Type | Organization |
| Authorized Contact | CHAIWON KIM CEO 770-446-0929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-05-10 |