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Southlake Dental Care Management

Dentist in Hoover, AL. Organization (NPI-2).

NPI number1124472956
StatusActive
Last updated in NPPESApr 18, 2016

Details

NPI
1124472956
Entity type
Organization (NPI-2)
Legal business name
Southlake Dental Care Management
Organization subpart
No
Enumeration date
Apr 18, 2016
Last updated
Apr 18, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist5772ALYes
122300000X Dentist3410AL
122300000X Dentist4159AL
122300000X Dentist5257AL
122300000X Dentist51171AL
122300000X Dentist6258AL
122300000X Dentist5423AL

Practice location

4501 Southlake Pkwy
Hoover, AL 35244-3644

Phone 205-988-5656 · Fax 205-988-3972

Mailing address

4501 Southlake Pkwy
Hoover, AL 35244-3644

Phone 205-988-5656 · Fax 205-988-3972

Authorized official

Karol Medina Poczatek
Dentist
2059885656

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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