Healthcare Provider Details

I. General information

NPI: 1619068822
Provider Name (Legal Business Name): LAUREN A METZGER DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 GEORGIAN DRIVE STE A
MOBILE AL
36609
US

IV. Provider business mailing address

505 GEORGIAN DRIVE STE A
MOBILE AL
36609
US

V. Phone/Fax

Practice location:
  • Phone: 251-342-1644
  • Fax: 251-342-1648
Mailing address:
  • Phone: 251-342-1644
  • Fax: 251-342-1648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREN A METZGER
Title or Position: OWNER
Credential: DMD
Phone: 251-342-1644