# CHILDREN AND TEEN DENTAL GROUP OF ALABAMA

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

## Provider details

- **NPI number:** 1285160804
- **Authorized official:** BRIAN SMITH (CFO)
- **Authorized official phone:** (770) 231-5348

## Contact information

- **Practice address:** 1713 HAMRIC DR E STE C, OXFORD, AL 36203
- **Practice address phone:** (256) 238-9233
- **Mailing address:** 2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
- **Mailing address phone:** (470) 207-3264

## 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:** 05/02/2017
- **Last updated:** 05/20/2026