| NPI | 1811034671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PORTIA ELLIS CARTER Co Owner 770-432-6070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2008-03-03 |