Organization
FAIRHOPE MODERN DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW JOSEPH KNIGHT DMD (PRESIDENT)
(256) 828-0793
Entity
Organization
Contact information
Practice address
106 LOTTIE LN, FAIRHOPE, AL 36532-2995
(251) 928-0400
Mailing address
106 LOTTIE LN, FAIRHOPE, AL 36532-2995
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5616
AL
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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