NPI | 1669698577 |
---|---|
Entity Type | Organization |
Authorized Contact | RONNIE LOUIS DYER President 706-745-9621 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 10023) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2010-08-09 |