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Organization

COMPLETE DENTAL DECATUR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TERESA JANETTE HAAKE (BILLING COORDINATOR)
(256) 258-3883
Entity
Organization

Contact information

Practice address
1241 POINT MALLARD PARKWAY, SUITE. 105, DECATUR, AL 35601
(256) 258-3866
Mailing address
120 W DUBLIN DR, SUITE. 202, MADISON, AL 35758-3155
(256) 258-3866
(256) 464-5763

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5311
AL

Other

Enumeration date
10/10/2012
Last updated
10/10/2012
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