NPI | 1114198108 |
---|---|
Doing Business As | ATHENS FAMILY DENTAL CENTER |
Entity Type | Organization |
Authorized Contact | ROBERT SAMUEL FOGG Business Manager 706-548-3279 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 006805) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 009000) |
Enumeration Date | 2008-03-18 |
Last Update Date | 2008-03-18 |