| NPI | 1669628533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES HERSCHEL POWELL Owner 706-227-0773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA 8795) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2008-08-12 |