Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DN009370 | GA |
NPI | 1003981317 |
---|---|
Provider Name | Dr. F Neal Pylant JR. |
First Address | Athens, GA 30606 |
Second Address | Athens, GA 30606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 23/09/2008 |