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General NPI Number Information
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NPI Number | 1417066275
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Entity Type | Organization
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Legal Business Name | FAIRFIELD DENTAL CENTER
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 4800 W. FAIRFIELD DRIVE
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City | PENSACOLA
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State | FL
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Zip | 32506
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Country | US
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Telephone | 850-456-9201
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Fax | 850-457-4073
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Provider Business Mailing Address
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Address Line | 4800 W. FAIRFIELD DRIVE
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City | PENSACOLA
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State | FL
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Zip | 32506
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Country | US
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Telephone | 850-456-9201
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Fax | 850-457-4073
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Authorized Official
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Title or Position | INSURANCE DEPT
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Name | MRS. LINDA S MCLAMB
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Credential |
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Telephone | 850-456-9201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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