| NPI | 1881451391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HETESH RANCHOD Medical Director 770-856-5071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-04-01 |