| NPI | 1902858004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT T WATTS, JR Oral Physician/Medical Director 228-388-5925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MS 25c0001059) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |