| NPI | 1457606592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M. B. BOYD Owner 706-738-1421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN014416) |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2012-07-15 |