Organization
COMPLETE DENTAL NORTH MADISON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA J HAAKE (BILLING COORDINATOR)
(256) 258-3883
Entity
Organization
Contact information
Practice address
120 W DUBLIN DR, SUITE. 202, MADISON, AL 35758-3155
(256) 258-3883
(256) 464-5763
Mailing address
8141 US 72, SUITE. G, MADISON, AL 35758
(256) 774-7228
(256) 464-5763
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5311
AL
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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