| NPI | 1083648216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA MILLIGAN ALLEN President 706-812-8220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN011455) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |