Organization
TUSCALOOSA DENTAL LLC
Active
Other names
Children's Dentistry for Alabama
Organization subpart
No
Provider details
NPI number
Authorized official
BLAIR BENNETT (CHIEF OPERATING OFFICER)
(334) 875-1330
Entity
Organization
Contact information
Practice address
1402 VETERANS MEMORIAL PKWY, SUITE A & B, TUSCALOOSA, AL 35404
(334) 875-1330
Mailing address
2425 MEDICAL CENTER PKWY, SELMA, AL 36701-7756
(334) 875-1330
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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