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General NPI Number Information
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NPI Number | 1790258671
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Entity Type | Organization
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Legal Business Name | STONECREEK ACQUISITIONS, L.L.C.
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 5750 BENTLEY WAY
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City | TRUSSVILLE
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State | AL
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Zip | 35173-6700
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Country | US
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Telephone | 205-655-5144
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Fax |
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Provider Business Mailing Address
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Address Line | 5750 BENTLEY WAY
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City | TRUSSVILLE
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State | AL
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Zip | 35173-6700
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Country | US
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Telephone | 205-655-5144
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. NANETTE LYNN CIPCIC
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Credential |
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Telephone | 205-655-5144
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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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