| NPI | 1881015451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL WALKER Credentialing Coordinator 404-410-1343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2013-12-26 |