| NPI | 1053823005 |
|---|---|
| Former Legal Business Name | LEWIS G HUMPHREYS, JR |
| Entity Type | Organization |
| Authorized Contact | JASMINE M. RODRIGUEZ Admin Asst. 334-792-7888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: AL 3595) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2021-09-29 |