Organization
GENESIS DENTAL GROUP LIBERTY PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAT HOLT (ADMINISTRATOR)
(334) 676-2320
Entity
Organization
Contact information
Practice address
8000 LIBERTY PKWY STE 126, VESTAVIA, AL 35242-7565
(205) 879-6880
Mailing address
3150 ZELDA CT, MONTGOMERY, AL 36106-2607
(334) 676-2320
(334) 593-2724
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/06/2017
Last updated
06/06/2017
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