| NPI | 1932212057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ROGER ROHDE President Owner 229-883-5115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA 011489) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: GA 011611) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-08-22 |