| NPI | 1811042690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA C DAVIS Owner/Orthodontist 770-471-5255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: GA DN011238) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2008-09-18 |