| NPI | 1649291733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH A HOWARD Office Manager 706-235-5899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA 012407) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |