| NPI | 1477825636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ALEX COLLIER Owner 662-236-1969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2869-95) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |