| NPI | 1427429661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITANY FABIAN MATIN President/Periodontist 334-444-0571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AL 5961) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |