| NPI | 1841785052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MAURY VANDERVOORT Owner 205-345-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 6103) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2020-01-02 |