| NPI | 1245407436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE MARSHALL Office Manager 251-666-3982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 3028) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |