| NPI | 1134775992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAHEL A KNIGHT CEO 229-313-5083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-12-11 |