| NPI | 1467938555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L LUTHER Office Manger 256-539-9635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 4387) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-12 |