| NPI | 1053669648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC CHRISTOPHER VANCE Owner 205-757-7509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 5830-C1) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |