| NPI | 1972450997 |
|---|---|
| Other Name | PROVIDENCE PARK FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MORGAN COLLINS Dentist 205-901-8164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2026-03-11 |
| Last Update Date | 2026-03-11 |