| NPI | 1427514199 |
|---|---|
| Other Name | DENTISTRY FOR AWESOME KIDS |
| Entity Type | Organization |
| Authorized Contact | JOHN BRYAN WAITS CEO 205-926-2992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-02-18 |