| NPI | 1982102653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY T SHIRLEY Owner 678-977-8119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012980) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |