| NPI | 1821248790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY MEDDERS MACKE President 678-908-5866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012427) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2008-09-26 |