| NPI | 1023234853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE D MARLOW President 478-745-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA 6880) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2008-10-01 |