Organization
CORNERSTONE DENTISTRY OF DECATUR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELVIN SCOTT WHITAKER DMD (PRESIDENT SECRETARY)
(256) 353-1481
Entity
Organization
Contact information
Practice address
1215 13TH AVE SE, DECATUR, AL 35601-4306
(256) 353-1481
Mailing address
1215 13TH AVE SE, DECATUR, AL 35601-4306
(256) 353-1481
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AL4965
AL
Other
Enumeration date
10/06/2006
Last updated
08/22/2020
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