| NPI | 1942575444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNDA KELLY CEO 205-514-7390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 5395) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |