| NPI | 1760796668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BROCK LIVINGSTON Member 256-764-1062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5182) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2017-01-19 |