| NPI | 1174722037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS ALLEN RICCARDI President 229-924-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 7795) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2007-07-12 |