Organization
PIKE ROAD DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YOLANDA WALTERS (OFFICE MANAGER)
(334) 819-7377
Entity
Organization
Contact information
Practice address
31 BRIDGE ST, PIKE ROAD, AL 36064
(334) 819-7377
(334) 819-7379
Mailing address
31 BRIDGE ST, PIKE ROAD, AL 36064-3843
(334) 819-7377
(334) 819-7379
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5159
AL
Other
Enumeration date
06/28/2018
Last updated
07/09/2018
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