| NPI | 1801141494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATADRI CHALASANI Dentist 770-718-9091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN012993) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: GA DN013184) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-19 |