| NPI | 1891017836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY MCLAIN Office Manager 334-749-5014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 0004800) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 0005367) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |