| NPI | 1447643523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA L MILLER Owner/Provider 205-789-5075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 5364) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |