| NPI | 1619516002 |
|---|---|
| Doing Business As | GEORGIA DENTAL ASSOCIATES OF TIFTON |
| Entity Type | Organization |
| Authorized Contact | NETTIE S HATCHER Director Of Operations 229-848-2685 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2022-01-25 |