| NPI | 1881766160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON BERRY BURNETT Dds Pc President 770-997-4598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN007288) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |