| NPI | 1982798658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE E. ALLEN Owner/President 256-461-9970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AL 4119) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AL 4066) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |