| NPI | 1144855701 |
|---|---|
| Doing Business As | MOUNTAIN BROOK SMILES |
| Entity Type | Organization |
| Authorized Contact | CRAIG ROUSSO Member 205-423-9140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2020-03-04 |