| NPI | 1790899490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J. BENINATO President/Owner 706-234-0718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery (Licence: GA 10834) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-01-25 |