| NPI | 1912434507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGH ELLEN CORLEY-ALLEN Office Manager 770-786-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA dn014323) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2017-05-15 |