| NPI | 1467571125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMAN TYRUS IVEY President 478-741-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA 7326) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |