| NPI | 1164972923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES H BANKS President 205-486-8601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 4826) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6238) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |