| NPI | 1083850150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY HIGGINBOTHAM Dr 706-548-2651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN010077) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: GA DN012547) |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2008-12-19 |