| NPI | 1194904094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARL LEE BIERDEMAN President 601-981-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MS OR15188) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-10-26 |