| NPI | 1891926382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL W MATHEWS Owner 334-277-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 3600) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5690) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2009-07-31 |