| NPI | 1033455647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MORGAN JACKSON President 706-845-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN010331) |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2012-12-31 |