# DANDRIDGE DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dandridge Dental Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962793893
- **Authorized official:** DR. MICHELLE NICOLE DANDRIDGE DMD (OWNER)
- **Authorized official phone:** (334) 699-2220

## Contact information

- **Practice address:** 1435 ROSS CLARK CIR, SUITE A-1, DOTHAN, AL 36301-4744
- **Practice address phone:** (334) 699-2220
- **Practice address fax:** (334) 699-2223
- **Mailing address:** 1435 ROSS CLARK CIR, SUITE A-1, DOTHAN, AL 36301-4744
- **Mailing address phone:** (334) 699-2220
- **Mailing address fax:** (334) 699-2223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 5492 | AL | Yes |

## Other

- **Enumeration date:** 04/26/2011
- **Last updated:** 04/26/2011