| NPI | 1154835775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BLACKSHER CONNOR Dentist 205-870-9871 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 2986) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6405) |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2017-11-17 |