Organization
BASSETT DENTAL SERVICES LLC
Active
Other names
BASSETT DENTAL SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RITA ROX CHATMAN (OFFICE MANAGER)
(205) 481-4825
Entity
Organization
Contact information
Practice address
901 S CEDAR AVE, DEMOPOLIS, AL 36732-3327
(334) 289-9978
(334) 289-6078
Mailing address
PO BOX 427, DEMOPOLIS, AL 36732-0427
(334) 289-9978
(334) 289-6078
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4216
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008804910
—
AL
01
—
851148
TRICARE
AL
01
—
92405
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
09/26/2008
Last updated
09/26/2013
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