NPI | 1649660713 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA L MILLER Owner/Provider 205-999-0979 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 5364) |
Enumeration Date | 2015-01-28 |
Last Update Date | 2015-01-28 |