Organization
PEDIATRIC DENTISTRY EAST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE NIMER YOUNG D.M.D (DENTIST)
(205) 655-1000
Entity
Organization
Contact information
Practice address
123 N CHALKVILLE RD, TRUSSVILLE, AL 35173-1376
(205) 655-1000
(205) 228-8044
Mailing address
123 N CHALKVILLE RD, TRUSSVILLE, AL 35173-1376
(205) 655-1000
(205) 228-8044
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4655
AL
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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