| NPI | 1548205636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAIRE SHIVERS Practice Administrator 706-860-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN007367) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2020-08-22 |