Organization · NPI-2

Alabama Dental Professionals, P.C.

Dentist, General Practice · Madison, AL

NPI number1851498059
StatusActive
Last updated in NPPESAug 1, 2017

Details

NPI
1851498059
Entity type
Organization (NPI-2)
Legal business name
Alabama Dental Professionals, P.C.
Organization subpart
Yes
Enumeration date
Sep 20, 2006
Last updated
Aug 1, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice––Yes

Other names

  • Plaza Boulevard Dental (Doing Business As)
  • Rousseau Family Dentistry (Doing Business As)

Practice location

136 Plaza Blvd
Suite A
Madison, AL 35758-1160

Phone 256-464-3556 · Fax 256-464-3553

Mailing address

136 Plaza Blvd
Suite A
Madison, AL 35758-1160

Phone 256-464-3556 · Fax 256-464-3553

Authorized official

Heather Pruemer
Credentialing Team Lead
2175408434

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