| NPI | 1649780222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WILLIAM SPICER President 706-910-3468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN015012) |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2017-10-09 |