| NPI | 1770029324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES TYLER GEISE President 205-331-9229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5853) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6107) |
| 122300000X Dentist (Licence: AL 3526) | |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |