| NPI | 1932325677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY WAYNE HUDSON President 256-882-7873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 3677) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: AL 12133) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |