| NPI | 1134235609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECIL B BRAY President 912-489-1386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 9793) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 10099) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-11-06 |