NPI | 1376727826 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN A. BUETTNER Owner 334-279-0760 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AL 4076) |
Additional Taxonomies | 122300000X Dentist (Licence: AL 5417) |
122300000X Dentist (Licence: AL 5636) | |
Enumeration Date | 2007-12-19 |
Last Update Date | 2013-12-11 |