Healthcare Provider Details

I. General information

NPI: 1962532002
Provider Name (Legal Business Name): DENTAL CARE OF ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N 3RD ST
GADSDEN AL
35901-3201
US

IV. Provider business mailing address

315 N 3RD ST
GADSDEN AL
35901-3201
US

V. Phone/Fax

Practice location:
  • Phone: 205-556-2980
  • Fax:
Mailing address:
  • Phone: 205-556-2980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number4341
License Number StateAL

VIII. Authorized Official

Name: DR. JAMES L WHITE
Title or Position: PRESIDENT
Credential: DDS
Phone: 205-556-2980