| NPI | 1649660473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA HOLLAND OLIVER Practice Administrator 478-746-7686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |