| NPI | 1952812737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DEANN SMITH Treatment Coordinator 770-974-3633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DNO14556) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2018-03-17 |