| NPI | 1407077415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP COPENHAVER Dentist 912-756-2936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012235) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2008-01-14 |