| NPI | 1396122834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA GUZMAN STAPPENBECK Pediatric Dentist 912-376-9296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2015-10-21 |