| NPI | 1841492329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS LAWSON DAVIDSON Owner Provider 478-452-3820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 6842) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-08-22 |