| NPI | 1578634515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER RONALD MCILWAIN President 205-556-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-04-01 |