Healthcare Provider Details

I. General information

NPI: 1760250641
Provider Name (Legal Business Name): REBECCA KATRINA CHAN LIM-FLORES DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA KATRINA CHAN LIM

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HUGHES RD STE 104
MADISON AL
35758-2444
US

IV. Provider business mailing address

20 HUGHES RD STE 104
MADISON AL
35758-2444
US

V. Phone/Fax

Practice location:
  • Phone: 256-864-9571
  • Fax: 256-850-7510
Mailing address:
  • Phone: 256-864-9571
  • Fax: 256-850-7510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD.007635-C1
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: