| NPI | 1497260624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA HARRIS Practice Administrator 205-803-1115 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2023-01-10 |