| NPI | 1205503398 |
|---|---|
| Doing Business As | FAYETTE ENDODONTICS |
| Entity Type | Organization |
| Authorized Contact | JOHN HAYCOCK Owner 706-877-3456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2021-08-25 |