| NPI | 1184795627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BURTON MONCRIEF President 706-549-5604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: GA 7455) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |