| NPI | 1427146489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP ANTHONY MITCHELL Owner 205-980-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 03787) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: AL 17041) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |