| NPI | 1013382316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN SMITH Office Manager 912-384-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN007456) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2015-12-11 |