| NPI | 1861694374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD L OUSLEY President 706-846-2218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA GA7225) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA GA7225) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-08-22 |