| NPI | 1144676826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOY HAGAN Pediatric Dentist 912-272-7656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN015083) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |