| NPI | 1861986622 |
|---|---|
| Doing Business As | SOUTHERN PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | COTY HULGAN President 256-467-3638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AL 6124) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |