| NPI | 1295978047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM W BROADFOOT CEO 229-244-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN007995) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2009-04-09 |