NPI | 1720181852 |
---|---|
Former Legal Business Name | EASTDALE DENTAL GROUP PC |
Entity Type | Organization |
Authorized Contact | KILLIAN JOSEPH HORNER Owner/President 334-271-4600 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2006-09-06 |
Last Update Date | 2020-08-22 |