| NPI | 1467937466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BLAKE GRAHAM Insurance Department Manager 205-647-3181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |