| NPI | 1528443546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY RAY EBERHART Doctor 256-927-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5112) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5161) |
| 122300000X Dentist (Licence: AL 4860) | |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-08-10 |