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General NPI Number Information
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NPI Number | 1033631528
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Entity Type | Organization
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Legal Business Name | AKRIDGE FAMILY DENTAL, INC.
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 07/17/2017
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Provider Practice Location Address
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Address Line | 5466 OLD SHELL RD
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City | MOBILE
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State | AL
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Zip | 36608-3046
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Country | US
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Telephone | 251-510-8668
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Fax |
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Provider Business Mailing Address
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Address Line | 6589 LUBARRETT WAY
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City | MOBILE
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State | AL
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Zip | 36695-3826
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Country | US
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Telephone | 251-510-8668
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BARBARA SMITH
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Credential |
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Telephone | 850-378-6233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 4968
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License Number State | AL
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