| NPI | 1215086533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY H AUGUSTINE Owner Orthodontist 706-660-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: GA 012299) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2008-06-17 |