| NPI | 1942862859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDON WILLIAM SMALLEY Oral Surgeon 706-340-3408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-07-01 |