| NPI | 1992963193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK CONRAD NASSETTA President 205-586-5806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 5294) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2008-05-26 |