| NPI | 1538554878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MICHAEL CAMPBELL President 706-207-1102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 87673189923) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2015-04-03 |