| NPI | 1447487939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN RETTERBUSH Dr/ Owner 229-244-1633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 9831) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2009-06-11 |