| NPI | 1861610081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH SCOTT CRAWFORD Owner 770-447-5311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA DN009310) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |