| NPI | 1528365848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL VANN Owner 205-508-3399 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL A15293) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2011-02-23 |