Organization
MOBILE BAY DENTAL, LLC
Active
Other names
Mobile Bay Dental & Vision
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE HANKINSON DMD (OWNER)
(251) 706-7960
Entity
Organization
Contact information
Practice address
1651 SCHILLINGER RD N, SEMMES, AL 36575-7409
(251) 706-7960
Mailing address
1651 SCHILLINGER RD N, SEMMES, AL 36575-7409
(251) 706-7960
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5226
AL
152W00000X
Optometrist
S-779-TA-178
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10161482
—
AL
Enumeration date
08/05/2014
Last updated
12/08/2016
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