| NPI | 1891809919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON NATHAN BOWIE Owner/Dentist 251-343-1794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 4905) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2011-02-14 |