| NPI | 1780799833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROBIN CARR Owner 229-732-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013297) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA 8936) |
| 122300000X Dentist (Licence: GA DN013194) | |
| 1223G0001X Dentist, General Practice (Licence: GA DN011110) | |
| 1223G0001X Dentist, General Practice (Licence: GA DN011237) | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: GA DN013242) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2025-09-11 |