| NPI | 1982153938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUZARD BENJAMIN Owner 404-617-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 13549) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |