| NPI | 1427107499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BURGESS HERBERT LEE Dentist 229-244-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DNO10225) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |