| NPI | 1811138258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN F TANNER Dentist 229-333-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: GA DN013182) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2009-03-16 |