| NPI | 1174064539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA LOCHER Office Manager 478-743-0901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012737) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-17 |