| NPI | 1770976763 |
|---|---|
| Doing Business As | DAWSONVILLE DISTINCTIVE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BILAL MANZUR Officer 706-265-2505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN014918) |
| Enumeration Date | 2015-03-14 |
| Last Update Date | 2015-03-14 |