| NPI | 1932854262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES THOMAS GARDINER Owner 256-383-8037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-07-06 |