| NPI | 1790143899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BENNETT Orthodontist 706-284-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2016-02-03 |