| NPI | 1104195346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE LEWIS MITCHELL Dentist 256-547-5471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 3057) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5859 C1) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |