| NPI | 1972716710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY A KAMELCHUK Dds Md 256-882-3312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-01-29 |