| NPI | 1336349166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA PERRY MOSES President 706-863-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012036) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |