| NPI | 1356793533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH STEVE SELLERS Dentist/Owner 912-253-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN15000) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2016-07-12 |