Healthcare Provider Details

I. General information

NPI: 1881646743
Provider Name (Legal Business Name): SARRELL REGIONAL DENTAL CENTER FOR PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 HAYNES ST
TALLADEGA AL
35160-2559
US

IV. Provider business mailing address

230 E 10TH ST SUITE 106
ANNISTON AL
36207-5784
US

V. Phone/Fax

Practice location:
  • Phone: 256-315-4950
  • Fax:
Mailing address:
  • Phone: 256-741-7340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY A PARKER
Title or Position: CEO
Credential:
Phone: 256-741-7340