| NPI | 1801916069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARDSON MICHAEL ODUM President 770-924-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA 10232, 10416) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |