| NPI | 1558708230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN SCOTT FOY President 334-279-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 4635) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5943) |
| 261QD0000X Clinic/Center Dental | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2024-08-23 |