| NPI | 1013009315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES D MCCARTHA Owner 334-283-8115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 3953) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5300) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |