| NPI | 1831316280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ROBERT HANSMANN Owner 770-977-1632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: GA 7874) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |