Treehouse Children'S Dentistry, LLC
Dentist, General Practice in Madison, AL. Organization (NPI-2).
NPI number1982245395
StatusActive
Last updated in NPPESOct 7, 2019
Details
- NPI
- 1982245395
- Entity type
- Organization (NPI-2)
- Legal business name
- Treehouse Children'S Dentistry, LLC
- Organization subpart
- No
- Enumeration date
- Oct 7, 2019
- Last updated
- Oct 7, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
7559 Highway 72 W Ste 108Madison, AL 35758-8816
Phone 256-890-4005 · Fax 256-890-4293
Mailing address
7559 Highway 72 W Ste 108Madison, AL 35758-8816
Phone 256-890-4005 · Fax 256-890-4293
Authorized official
Wesley Burton Moffett
Owner
2568904005
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