| NPI | 1902940059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | P MIKE UPTON Orthodontist 205-752-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AL AL 4470) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-08-22 |