| NPI | 1336476530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER LEE MYERS Owner 912-408-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA Dn013413) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2009-11-09 |