| NPI | 1831241744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND C. LYEW Dentist Chief Executive Officer 678-344-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 10955) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 10287) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |