| NPI | 1831407634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR LANCE COLLIER Manager 706-494-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN013514) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-10-08 |