| NPI | 1720129307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT E. WILLIS President 256-464-7873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: AL 16039) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2014-08-20 |