| NPI | 1417064270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES GRADY President 334-749-3436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 2956CS) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2016-10-07 |