| NPI | 1013414994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AINSLEE BOSWELL Administrative Assistant 205-823-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AL 4659) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |