NPI | 1700273208 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON R MILLER Physician/Owner 256-265-4950 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 25550) |
Enumeration Date | 2015-04-22 |
Last Update Date | 2015-04-22 |