| NPI | 1104152404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ASHLEY MOORMAN Owner/Dentist 229-242-4441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN011637) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2009-10-22 |