| NPI | 1124104575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTHA MARIA DIEGUEZ-MARINO Orthodontist 205-980-4744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AL 4224) |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2020-08-22 |