| NPI | 1417029380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ESTES KOONCE President 256-764-4533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 2769) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |