| NPI | 1922150226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK D MASON President 404-344-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012710) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |