111N00000X
Dallas, GA
Specialty
111N00000X
Credential
DC
NPI
1710008412
110 Evans Mill Dr, Dallas, GA 30157
(678) 813-2741Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 111n00000x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 111N00000X