| NPI | 1124472956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAROL MEDINA POCZATEK Dentist 205-988-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5772) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 3410) |
| 122300000X Dentist (Licence: AL 4159) | |
| 122300000X Dentist (Licence: AL 5257) | |
| 122300000X Dentist (Licence: AL 51171) | |
| 122300000X Dentist (Licence: AL 6258) | |
| 122300000X Dentist (Licence: AL 5423) | |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |