| 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 |