| NPI | 1407223126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS MARTINOLAS President 912-816-2155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics | |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2016-12-06 |