Organization
ALEXANDRA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANT HAYNIE DMD (DENTIST)
(205) 467-0387
Entity
Organization
Contact information
Practice address
654 VALLEY CUB DR, ALEXANDRIA, AL 36250-4200
(256) 847-1111
Mailing address
654 VALLEY CUB DR, ALEXANDRIA, AL 36250-4200
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171653
—
AL
Enumeration date
03/06/2018
Last updated
03/06/2018
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