| NPI | 1912484676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA CRAWFORD Owner 256-534-3337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 4011) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-07-25 |