| NPI | 1053696781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BEAUDREAU Owner/Dentist 912-330-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 09617) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2011-10-13 |