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General NPI Number Information
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NPI Number | 1053987669
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Entity Type | Organization
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Legal Business Name | ALABAMA DENTAL MANAGEMENT SERVICES
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 274 N 3RD ST
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City | GADSDEN
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State | AL
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Zip | 35901-3201
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Country | US
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Telephone | 256-459-5309
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Fax |
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Provider Business Mailing Address
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Address Line | 274 N 3RD ST
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City | GADSDEN
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State | AL
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Zip | 35901-3201
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Country | US
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Telephone | 256-459-5309
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LAUREN CRANFORD
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Credential |
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Telephone | 256-459-5309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 292200000X
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Taxonomy Name | Dental Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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