| NPI | 1558822759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY SHELLEY Owner/Orthodontist 334-549-1785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2019-03-29 |