| NPI | 1568621191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA D SPEIGNER Financial Coordinator 334-793-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5119) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 3214) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2015-02-04 |