| NPI | 1801915236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY HARRADINE Owner 205-933-1291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5048) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: AL 5077) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |