| NPI | 1891156576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS MARGESON Owner 229-226-6875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA GA11010) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2016-03-09 |