| NPI | 1922195155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICKA EDMONDS Dentist 404-344-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 121923LGB) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |