| NPI | 1083883276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EDWIN LOVE President 256-332-6073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AL AL3951) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2008-02-21 |