Organization
SRD ATHENS, PLLC
Active
Other names
SRD Athens
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTYN SHIELDS (CONTROLLER)
(256) 320-5903
Entity
Organization
Contact information
Practice address
22026 GATEWAY BLVD, SUITES A, ATHENS, AL 35613
(256) 383-8037
Mailing address
110 E 5TH ST, TUSCUMBIA, AL 35674-2410
(256) 383-4990
(265) 383-2182
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
11/22/2022
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