| NPI | 1225586498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANDREW BRITTINGHAM VP/Dentist 706-860-4190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014829) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 9859) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |