| NPI | 1790648319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER SHI CEO 770-845-0727 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-12-09 |
| Last Update Date | 2025-12-09 |