| NPI | 1114392107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. DAVID STANLEY Member/Owner 334-801-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5221) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2016-02-17 |