| NPI | 1497119945 |
|---|---|
| Former Legal Business Name | ROBERT L. BIRDWELL DDS, PC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL LACORTE President 888-833-8441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2018-05-17 |