| NPI | 1235377045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRUCE ROGERS Orthodontist 706-733-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2009-02-02 |