| NPI | 1912328527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY PATTERSON Receptionist 205-436-2683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5374) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5334) |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2013-12-27 |