| NPI | 1437677226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL KEITH ROBERSON President 205-871-2838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AL 4195) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2017-09-01 |