| NPI | 1992738165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA LEACH Chief Financial Officer 770-977-0364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2024-03-01 |