| NPI | 1700158466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW R ALLGOOD Owner 706-863-3290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA dn008111) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-04-23 |