| NPI | 1215573845 |
|---|---|
| Former Legal Business Name | HOMETOWN FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JENNIFER AMOS Office Manager 706-387-0305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2019-11-19 |