Organization
SARRELL REGIONAL DENTAL CENTER FOR PUBLIC HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD CRUSE (PRESIDENT)
(629) 999-5006
Entity
Organization
Contact information
Practice address
1013 MEDICAL CENTER PKWY STE 103, SELMA, AL 36701-6742
(334) 410-1603
(334) 410-1604
Mailing address
230 E 10TH ST STE 106, ANNISTON, AL 36207-5771
(256) 741-7340
(256) 741-7373
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128566
—
AL
Enumeration date
05/24/2011
Last updated
03/28/2018
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