| NPI | 1548596141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA ABERNATHY Business Office Director 877-705-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA 10762) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2009-11-02 |