| NPI | 1609248988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER M. MILLER President 706-270-5775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| 1223E0200X Dentist, Endodontics | |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2017-04-06 |