| NPI | 1891829651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE M DELICE Dentist 770-474-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN011843) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-07-28 |