| NPI | 1770902850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE HUGH TRAMMELL Sole Member 334-277-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 5863) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |