| NPI | 1992847610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ALEXANDER President 770-509-2310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: GA 010295) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |