| NPI | 1992077804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL R MCKOY President 678-517-8368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA dn012765) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |