| NPI | 1063490365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALEXANDER BOSQUE President 912-355-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN009619) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2016-05-09 |