| NPI | 1295828937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY HOLLEY MCLAIN Office Manager 334-749-5014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 0005367) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 0004800) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2011-03-03 |