| NPI | 1841415874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C WILSON Partner 912-354-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA 011165) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2022-03-08 |