Healthcare Provider Details

I. General information

NPI: 1841383809
Provider Name (Legal Business Name): WARRIOR FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 NORTH MAIN STREET
WARRIOR AL
35180
US

IV. Provider business mailing address

211 NORTH MAIN STREET
WARRIOR AL
35180
US

V. Phone/Fax

Practice location:
  • Phone: 205-647-3181
  • Fax: 205-647-1134
Mailing address:
  • Phone: 205-647-3181
  • Fax: 205-647-1134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ROBERT EDMUNDSON HAMRIC
Title or Position: ADMINISTRATOR
Credential: DMD
Phone: 205-647-6647