Organization
PROGRESSIVE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN PATRICK BARRILLEAUX DDS (PRESIDENT)
(256) 451-7242
Entity
Organization
Contact information
Practice address
11093 AL HIGHWAY 71, PISGAH, AL 35765-7713
(256) 451-7242
Mailing address
11093 AL HIGHWAY 71, PISGAH, AL 35765-7713
(256) 451-7242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4490
AL
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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