| NPI | 1518056662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA WOODALL BAKER President/Orthodontist 706-602-0540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 10874) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |