| NPI | 1457833972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KEITH MILLER Owner 251-867-5625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 4452) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2018-08-31 |