| NPI | 1497766844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JEFFREY CREWS President 706-291-2901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: GA DN008939) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-08-22 |