| NPI | 1144470170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A. PRUITT Personal Representative Of Estate 256-927-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5219) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2008-09-26 |