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General NPI Number Information
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NPI Number | 1902790603
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Entity Type | Organization
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Legal Business Name | ALACHUA DENTAL, PLLC
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 14211 NW 150TH AVE
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City | ALACHUA
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State | FL
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Zip | 32615-8537
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Country | US
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Telephone | 386-462-4635
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Fax |
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Provider Business Mailing Address
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Address Line | 3909 NEWBERRY RD STE G
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City | GAINESVILLE
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State | FL
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Zip | 32607-2367
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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 | INSURANCE COORDINATOR
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Name | HALEY NEEDHAM
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Credential |
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Telephone | 386-462-4635
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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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