| NPI | 1437289303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL GAINES THOMAS Owner 251-345-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 3282) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-12-31 |