| NPI | 1215024690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN SCOTT WHITAKER President Secretary 256-353-1481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL al4965) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |