| NPI | 1124432166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD ALAN BETHEA Denitst/Owner 912-285-1218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN011225) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |