| NPI | 1881949725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN WARREN JOHNSON Owner 205-218-4123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AL 5686) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |