| NPI | 1851664221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC J STERETT Managing Member 706-796-6269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN 013883) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA GADN010958) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2012-02-16 |