| NPI | 1841319449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KETANKUMAR G PATEL Dentist 770-534-0697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA dn007359) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA dn012835) |
| 122300000X Dentist (Licence: GA dn008017) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2015-01-12 |