| NPI | 1689028300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD A DURHAM Owner 912-234-8282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 9631) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |