| NPI | 1205186863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER E. HALL Owner 912-264-6420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN011864) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2012-10-15 |