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Organization
PEDIATRIC DENTAL ASSOCIATES OF CULLMAN, LLC
Active
Organization
PEDIATRIC DENTAL ASSOCIATES OF CULLMAN, LLC
Active
Other names
Nassetta Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CHAMBLISS DDS (OWNER)
(205) 453-0314
Entity
Organization
Contact information
Practice address
1705 MAIN AVE SW STE A, CULLMAN, AL 35055-7207
(256) 739-6000
Mailing address
1705 MAIN AVE SW STE A, CULLMAN, AL 35055-7207
(256) 739-6000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0005181
AL
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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