| NPI | 1912005752 |
|---|---|
| Other Name | DENTFIRST - PERIMETER |
| Entity Type | Organization |
| Authorized Contact | GINA S JACKSON Contracts, Credentialing Mgr 770-446-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA 7981) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-07-16 |