Organization
NORTH MOBILE DENTAL MEDICAID, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHONN M FARNI DMD (OWNER)
(251) 675-4313
Entity
Organization
Contact information
Practice address
1064 INDUSTRIAL PKWY, SARALAND, AL 36571-3720
(251) 675-4313
(251) 675-4355
Mailing address
1064 INDUSTRIAL PKWY, SARALAND, AL 36571-3720
(251) 675-4313
(251) 675-4355
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4781
AL
261QD0000X
Dental Clinic/Center
4782
AL
261QD0000X
Dental Clinic/Center
4784
AL
261QD0000X
Dental Clinic/Center
5712
AL
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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