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General NPI Number Information
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NPI Number | 1538823828
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Entity Type | Organization
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Legal Business Name | N DEAN DENTAL LLC
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Dates
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Enumeration Date | 10/24/2021
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Last Update Date | 10/24/2021
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Provider Practice Location Address
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Address Line | 867 N DEAN RD
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City | AUBURN
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State | AL
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Zip | 36830-9419
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Country | US
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Telephone | 334-887-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 867 N DEAN RD
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City | AUBURN
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State | AL
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Zip | 36830-9419
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Country | US
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Telephone | 334-887-6111
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. JOSHUA MATHIS
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Credential | DDS
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Telephone | 918-852-4854
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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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