| NPI | 1134653801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE ELLIS HAYNIE Owner,President 256-504-9638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 5829) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |