Organization
TOOTH BUDS AT LAGOON PARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J. DAVID STANLEY D.M.D. (MEMBER/OWNER)
(334) 801-9800
Entity
Organization
Contact information
Practice address
553 N EASTERN BLVD, MONTGOMERY, AL 36117-2213
(334) 801-9800
(334) 801-9848
Mailing address
553 N EASTERN BLVD, MONTGOMERY, AL 36117-2213
(334) 801-9800
(334) 801-9848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5221
AL
Other
Enumeration date
12/02/2015
Last updated
02/17/2016
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