| NPI | 1336310317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA L SPIVEY Office Manager 229-242-0063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 012344) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |