| NPI | 1821496134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY SHAWN GURLEY Doctor/Owner 770-664-1244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN011186) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |