Organization
DENTAL ASSOCIATES OF ATHENS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI WRENN (ADMINISTRATIVE ASSISTANT)
(256) 353-5600
Entity
Organization
Contact information
Practice address
1005 W MARKET ST, ATHENS, AL 35611-2454
(256) 232-1404
(256) 230-6738
Mailing address
1005 W MARKET ST, ATHENS, AL 35611-2454
(256) 232-1404
(256) 230-6738
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5540
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-43170
BCBS AL
AL
Enumeration date
02/17/2012
Last updated
02/17/2012
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