| NPI | 1053806331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA WALTERS Office Manager 334-819-7377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 5159) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-07-09 |