| NPI | 1821144882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS DALE TWILLEY President 706-886-1424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 8302) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-07-15 |