| NPI | 1609022722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH FRANK TICHANSKY Owner 205-326-6613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 3132) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2008-08-08 |