| NPI | 1215270970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUKETU J. PATEL Owner 912-764-5435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: GA DN014505) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2024-05-22 |