# CHILDREN AND TEEN DENTAL GROUP OF ALABAMA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205295292
- **Authorized official:** BRIAN SMITH (CEO)
- **Authorized official phone:** (770) 231-5348

## Contact information

- **Practice address:** 1825 MCFARLAND BLVD N STE D, TUSCALOOSA, AL 35406-2236
- **Practice address phone:** (205) 758-3341
- **Mailing address:** 2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
- **Mailing address phone:** (727) 784-2721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 02/18/2016
- **Last updated:** 05/20/2026