| NPI | 1073785986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY M. GRAHAM Doctor/Owner 478-452-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN010029) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-07-15 |