| NPI | 1154955805 |
|---|---|
| Doing Business As | THE GRAND FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | LARESEA WOODS Dentist/Part Owner 334-590-4223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-04-09 |