| NPI | 1750804225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAYNE HILLEN HEERSINK President 334-702-1101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2022-07-21 |