| NPI | 1841329083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELLIE L NOBLET Office Manager 251-342-5323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 3115) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |