| NPI | 1063828499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LEE KELLER Dentist/Owner 706-225-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN014428) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |