| NPI | 1578714473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY C MATTHEWS Co Owner 334-793-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5083) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 2781) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |