| NPI | 1932282563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN PAGITT Financial Coordinator 228-896-4325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: GA PER24293) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |