| NPI | 1093844060 |
|---|---|
| Doing Business As | DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARILYN J SAWYER Executive Director 251-578-1163 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2008-02-12 |