| NPI | 1760551063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WORCESTER PUTNAM Member 706-745-6848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 7788) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |