| NPI | 1437602281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLESIA MCLIN Dentist 205-323-0454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AL 6130) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-07-28 |