| NPI | 1275755860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BRADSHAW Administrator 334-792-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |