NPI | 1003984055 |
---|---|
Entity Type | Organization |
Authorized Contact | MARGARET S HARTWIG President 478-953-0903 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA GA10847) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL FL11606) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2012-05-21 |