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General NPI Number Information
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NPI Number | 1639094659
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Entity Type | Organization
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Legal Business Name | NORTH JEFFERSON DENTAL CARE, LLC
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 8301 HIGHWAY 31 N STE 109
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City | MORRIS
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State | AL
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Zip | 35116-1305
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Country | US
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Telephone | 205-647-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 8301 HIGHWAY 31 N STE 109
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City | MORRIS
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State | AL
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Zip | 35116-1305
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Country | US
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Telephone | 205-647-2050
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | CHAD HENDRICKS
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Credential |
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Telephone | 612-859-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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