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General NPI Number Information
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NPI Number | 1598904765
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Entity Type | Organization
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Legal Business Name | SNL DENTAL P.C.
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 200 BOB WALLACE AVE SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-3809
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Country | US
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Telephone | 256-539-6634
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Fax |
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Provider Business Mailing Address
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Address Line | 200 BOB WALLACE AVE SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-3809
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MATTEW B LIMBAUGH
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Credential | D.M.D.
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Telephone | 205-329-1174
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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 | 5277
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License Number State | AL
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