| NPI | 1558562074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE CYRIL MADSON Owner 912-764-9187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 8617) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2014-10-23 |