Organization
SECD TALLASSEE LLC
Active
Other names
Tallassee Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
SARA NORTHCUTT DDS (OWNER)
(615) 319-4918
Entity
Organization
Contact information
Practice address
1608 GILMER AVE, TALLASSEE, AL 36078-2314
Mailing address
1040 NATCHEZ VALLEY LN, FRANKLIN, TN 37064-4704
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6397
AL
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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