# PEDIATRIC DENTAL CLINIC

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

## Provider details

- **NPI number:** 1861996035
- **Authorized official:** DAVID MERRITT (DR.)
- **Authorized official phone:** (256) 766-0270

## Contact information

- **Practice address:** 162 ANA DR, FLORENCE, AL 35630-1759
- **Practice address phone:** (256) 766-0270
- **Practice address fax:** (256) 766-8328
- **Mailing address:** 162 ANA DR, FLORENCE, AL 35630-1759
- **Mailing address phone:** (256) 766-0270
- **Mailing address fax:** (256) 766-8328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3267 | AL | Yes |

## Other

- **Enumeration date:** 03/21/2018
- **Last updated:** 03/21/2018