| NPI | 1134421746 |
|---|---|
| Former Legal Business Name | DENTAID DENTAL CENTER PC |
| Entity Type | Organization |
| Authorized Contact | GEORGE DAVID JOHNSON President 205-271-6851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AL 4794) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |