| NPI | 1104070218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEVELAND MANN Owner 229-435-6627 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN010046) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2008-11-17 |