| NPI | 1992101539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASSAN MOETI Owner 770-923-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN013813) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2014-11-10 |