| NPI | 1497774038 |
|---|---|
| Doing Business As | DAWSONVILLE DISTINCTIVE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BILAL MANZUR Officer 706-265-2505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DN014918) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN014918) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-06-10 |