| NPI | 1194177212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M STEWART Office Manager 334-281-2451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 21936) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |