NPI | 1457570111 |
---|---|
Entity Type | Organization |
Authorized Contact | JERRY LEE WILLIAMS President 770-386-5851 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 10433) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2020-08-22 |