| NPI | 1053987669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN CRANFORD Practice Manager 256-459-5309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 292200000X Dental Laboratory |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-06-03 |