| NPI | 1134598246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ELLEN DULING Member 256-534-1475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 6157) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2023-04-26 |