| NPI | 1902593205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN L GOLDEN Owner Dentist 770-689-8150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |