| NPI | 1801246079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARISSE CASWELL Owner 770-632-7090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013163) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2016-06-17 |