| NPI | 1225318264 |
|---|---|
| Doing Business As | SOUTHERN DENTAL ARTS |
| Entity Type | Organization |
| Authorized Contact | RYAN KEITH STAEHLING Member, Manager, And Organizer 225-802-1345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8896) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-12-03 |