| NPI | 1316584758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER TRADD HARTER President 706-549-4748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |