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Organization
ADVANTAGE DENTAL ORAL HEALTH AND VISION CENTER OF ALABAMA, P.C.
Active
Organization
ADVANTAGE DENTAL ORAL HEALTH AND VISION CENTER OF ALABAMA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRIE EDMONDSON (MANAGER, LICENSING & CREDENTIALING)
(629) 999-5014
Entity
Organization
Contact information
Practice address
1141 JASPER DENNIS RD, CLANTON, AL 35045-3783
(205) 312-0001
(205) 312-0002
Mailing address
PO BOX 411714, BOSTON, MA 02241-6805
(629) 999-5014
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
NULL
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121795
—
AL
Enumeration date
08/11/2010
Last updated
03/04/2024
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