| NPI | 1922764653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY EDWARDS BEAL Owner 404-349-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2021-11-17 |