| NPI | 1831466952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG N FIEVET President 770-979-3760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: GA DN008762) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2011-11-17 |