| NPI | 1003063058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA NORSTEDT Office Manager 251-342-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL LNO 4455) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |