| NPI | 1073063228 |
|---|---|
| Doing Business As | YOUTH DENTISTRY OF MACON |
| Entity Type | Organization |
| Authorized Contact | LINDA SUSAN ZOELLER Authorized Official 615-988-2627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN015152) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2018-07-05 |