| NPI | 1053442608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LES J. KICKLIGHTER President 912-489-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012401) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |