| NPI | 1528179033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVERY PATTON BEALL Owner 706-882-2597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN00835) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |