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Organization
MATTHEW TICOLA DMD LLC
Active
Organization
MATTHEW TICOLA DMD LLC
Active
Other names
Little Critters Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW TICOLA (MANAGER)
(256) 505-8954
Entity
Organization
Contact information
Practice address
11521 US HIGHWAY 431 STE V, GUNTERSVILLE, AL 35976-5671
(256) 505-8954
Mailing address
11521 US HIGHWAY 431 STE V, GUNTERSVILLE, AL 35976-5671
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D0005747-C
AL
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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