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General NPI Number Information
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NPI Number | 1487153557
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Entity Type | Organization
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Legal Business Name | CHELSEA ORTHODONTICS
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 02/05/2018
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Provider Practice Location Address
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Address Line | 300 JADE PARK STE 301
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City | CHELSEA
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State | AL
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Zip | 35043-8349
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Country | US
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Telephone | 205-678-2770
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Fax | 205-678-2775
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Provider Business Mailing Address
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Address Line | 300 JADE PARK STE 301
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City | CHELSEA
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State | AL
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Zip | 35043-8349
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Country | US
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Telephone | 205-678-2770
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Fax | 205-678-2775
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Authorized Official
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Title or Position | FRONT DESK
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Name | LORI CHENEY
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Credential |
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Telephone | 205-678-2770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 4889
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License Number State | AL
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