| NPI | 1962687608 |
|---|---|
| Doing Business As | PREMIERE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ANDREW JONATHAN CRAFT Member 205-621-5304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5013) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 5006) |
| 1223G0001X Dentist, General Practice (Licence: AL 3975) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL 4187) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2008-01-04 |