| NPI | 1942394820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY ANDREW FIKES Owner Dentist 205-345-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 3162) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5177) |
| 1223G0001X Dentist, General Practice | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |