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Stonecreek Dental Of Alabama

Clinic/Center, Dental in Birmingham, AL. Organization (NPI-2).

NPI number1114656303
StatusActive
Last updated in NPPESJun 6, 2022

Details

NPI
1114656303
Entity type
Organization (NPI-2)
Legal business name
Stonecreek Dental Of Alabama
Organization subpart
No
Enumeration date
Jun 6, 2022
Certification date
May 26, 2022
Last updated
Jun 6, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QD0000X Clinic/Center, Dental––Yes

Other names

  • Mst Dental (Doing Business As)

Practice location

4702 Misty Ridge Cir
Birmingham, AL 35235-8665

Phone 205-853-1136

Mailing address

4702 Misty Ridge Cir
Birmingham, AL 35235-8665

Phone 205-853-1136 · Fax 205-769-6245

Authorized official

Veronica Jackson
Revenue Cycle Manager
2059191750

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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