| NPI | 1942403795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM P HINES Owner 706-884-2655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: GA 8424) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2020-08-22 |