| NPI | 1386917631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI WRENN Administrative Assistant 256-353-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5540) |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2012-02-17 |