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General NPI Number Information
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NPI Number | 1215301700
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Entity Type | Organization
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Legal Business Name | FLINT RIVER DENTISTRY LLC
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Dates
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Enumeration Date | 11/20/2015
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 2130 WINCHESTER RD NE SUITE D
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City | HUNTSVILLE
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State | AL
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Zip | 35811
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Country | US
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Telephone | 256-859-8066
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Fax | 855-259-1075
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Provider Business Mailing Address
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Address Line | 2130 WINCHESTER RD NE SUITE D
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City | HUNTSVILLE
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State | AL
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Zip | 35811
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Country | US
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Telephone | 256-859-8066
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Fax | 855-259-1075
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Authorized Official
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Title or Position | PAYOR ENROLLMENT SPECIALIST TEAM LE
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Name | PAOLA LOPEZ
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Credential |
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Telephone | 972-869-3789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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