| NPI | 1518004449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANE VERLYN BARKER Owner, President 706-546-7390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: GA DN011849) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |