| NPI | 1104193531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINKSTON T CRYER Dentist 706-563-0327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: GA DN012488) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |