NPI | 1215135280 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURENCE MATTHEW HAGE Owner 228-864-3416 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3271-03) |
Enumeration Date | 2007-07-10 |
Last Update Date | 2007-07-10 |