| NPI | 1447619689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA J HAAKE Billing Coordinator 256-258-3883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5311) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-16 |