| NPI | 1871719773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LIN PUGH Accts. Mgr. 770-973-7227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DNO12629) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2014-03-28 |