| NPI | 1912592692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA PERKINS Onboarding Specialist 770-692-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2021-03-04 |