| NPI | 1003205089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W HUSKEY Ower 334-745-6295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 3215) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: AL 3215) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-06-25 |