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General NPI Number Information
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NPI Number | 1306302674
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Entity Type | Organization
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Legal Business Name | JAMES DREADING FAMILY DENTISTRY, P.C.
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 1203 MASON RIDGE DR
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City | DEMOPOLIS
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State | AL
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Zip | 36732-3607
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Country | US
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Telephone | 334-289-1206
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Fax | 334-289-1228
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Provider Business Mailing Address
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Address Line | 1203 MASON RIDGE DR
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City | DEMOPOLIS
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State | AL
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Zip | 36732-3607
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Country | US
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Telephone | 334-289-1206
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Fax | 334-289-1228
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. JAMES DANIEL DREADING
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Credential | DMD
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Telephone | 334-289-1206
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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 |
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License Number State |
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