| NPI | 1548473754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J GREGORY MORRIS President 229-985-4715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 11208) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |