| NPI | 1306868401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE J COLLINS Dentist 334-642-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 4359) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: AL 5480) |
| 1223G0001X Dentist, General Practice (Licence: AL 4617) | |
| 124Q00000X Dental Hygienist (Licence: AL 5836) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-03-07 |