| NPI | 1225256639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY L MCCULLOCH President 770-315-2529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN010601) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2015-04-20 |