| NPI | 1407276041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN WORTHAM Dentist 205-871-2591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 6035) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2014-04-22 |