| NPI | 1518470053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE JOSHUA MARTIN Dentist 912-966-2102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN014447) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |