| NPI | 1235554809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MOULTHROP Owner 334-793-3651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 2529) |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2014-02-19 |