| NPI | 1992041743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MATHEWS Doctor 334-277-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AL 3600) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AL 5690) |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2012-12-26 |