| NPI | 1942535091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA G. BRACKETT CEO 404-289-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA 0010117) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2009-10-07 |