| NPI | 1164793741 |
|---|---|
| Former Legal Business Name | BRIAN BEAUDREAU, LLC |
| Entity Type | Organization |
| Authorized Contact | BRIAN BEAUDREAU Owner 912-354-9204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 09617) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |