| NPI | 1528446150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LESLIE HOBGOOD Owner 225-229-9159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6303) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2015-06-30 |