| NPI | 1881861631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D. STANLEY Dentist/Vice President 334-358-6411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 5199) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 2865) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 4869) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 5053) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 5221) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2015-10-01 |