| NPI | 1114199973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISA DONN Manager 334-793-9885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 4974) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |