Organization
HUNTSVILLE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP BRENT ELLEDGE DMD (OWNER)
(256) 534-5028
Entity
Organization
Contact information
Practice address
2314 PANSY ST SW, HUNTSVILLE, AL 35801-3803
(256) 534-5028
(256) 534-5073
Mailing address
2314 PANSY ST SW, HUNTSVILLE, AL 35801-3803
(256) 534-5028
(256) 534-5073
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5313
AL
Other
Enumeration date
09/16/2006
Last updated
08/15/2007
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