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General NPI Number Information
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NPI Number | 1831377993
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Entity Type | Organization
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Legal Business Name | MCCALLA ORTHODONTICS AND PEDIATRIC DENTISTRY, P.C.
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 4764 EASTERN VALLEY RD SUITE 104-106
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City | MC CALLA
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State | AL
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Zip | 35111-3469
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Country | US
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Telephone | 205-477-8004
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Fax | 205-477-8214
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Provider Business Mailing Address
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Address Line | 4764 EASTERN VALLEY RD STE 104-106
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City | MC CALLA
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State | AL
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Zip | 35111-3469
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Country | US
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Telephone | 205-477-8004
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. OLGA M. SANCHEZ-HERNANDEZ
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Credential | D.M.D., M.S., M.S.
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Telephone | 205-477-8004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 4956
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License Number State | AL
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