| NPI | 1922411297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MCCABE Managing Member 228-497-9844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS 3541-10) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |