| NPI | 1265659437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON REID MCGIBONY President 912-764-4403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012077) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |