Organization
MADISON PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESLEY MOFFETT D.M.D. (MEMBER)
(205) 792-0003
Entity
Organization
Contact information
Practice address
7559 HIGHWAY 72 W, SUITE C7/C8, MADISON, AL 35758-8811
(256) 527-4590
(256) 890-4293
Mailing address
7559 HIGHWAY 72 W, MADISON, AL 35758-8811
(256) 527-4590
(256) 890-4293
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/27/2010
Last updated
04/15/2013
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