| NPI | 1871976399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA L MONCUS Dentsit/Owner 256-638-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 5126) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 6198) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |