Pike Road Dental, LLC
Clinic/Center, Dental in Pike Road, AL. Organization (NPI-2).
NPI number1053806331
StatusActive
Last updated in NPPESJul 9, 2018
Details
- NPI
- 1053806331
- Entity type
- Organization (NPI-2)
- Legal business name
- Pike Road Dental, LLC
- Organization subpart
- No
- Enumeration date
- Jun 28, 2018
- Last updated
- Jul 9, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 5159 | AL | Yes |
Practice location
31 Bridge StPike Road, AL 36064
Phone 334-819-7377 · Fax 334-819-7379
Mailing address
31 Bridge StPike Road, AL 36064-3843
Phone 334-819-7377 · Fax 334-819-7379
Authorized official
Yolanda Walters
Office Manager
3348197377
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