Healthcare Provider Details

I. General information

NPI: 1528735545
Provider Name (Legal Business Name): GREENE COUNTY HEALTH DEPT. DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 MORROW AVE
EUTAW AL
35462-1109
US

IV. Provider business mailing address

412 MORROW AVE
EUTAW AL
35462-1109
US

V. Phone/Fax

Practice location:
  • Phone: 205-372-9361
  • Fax: 205-372-9283
Mailing address:
  • Phone: 205-372-9361
  • Fax: 205-372-9283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ARNITA SHEPHERD
Title or Position: DIRECTOR
Credential: MSW
Phone: 334-206-7065