| NPI | 1932268216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D WITHCER Dentist Owner 770-535-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA 9608) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN0009359) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2012-09-27 |