| NPI | 1457572125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A LAWRENCE Owner 706-327-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 011761) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2010-09-20 |