| NPI | 1043760622 |
|---|---|
| Doing Business As | GULF COAST DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRADLEY CLAY President 251-943-5632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 6083C) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |