Lee Redditt Dmd, PLLC
Clinic/Center, Dental in Theodore, AL. Organization (NPI-2).
NPI number1164096749
StatusActive
Last updated in NPPESMay 18, 2021
Details
- NPI
- 1164096749
- Entity type
- Organization (NPI-2)
- Legal business name
- Lee Redditt Dmd, PLLC
- Organization subpart
- No
- Enumeration date
- May 18, 2021
- Certification date
- May 18, 2021
- Last updated
- May 18, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
5721 Highway 90 Ste ATheodore, AL 36582-3601
Phone 251-653-1242 · Fax 251-653-1242
Mailing address
5721 Highway 90 Ste ATheodore, AL 36582-3601
Phone 251-653-1242
Authorized official
Melissa G Underwood
Office Manager
2516531300
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