Organization
FAIRHOPE COSMETIC AND FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES THEODORE MELTON JR. DMD (OWNER)
(251) 990-7797
Entity
Organization
Contact information
Practice address
101 FLY CREEK AVE STE 301, FAIRHOPE, AL 36532-8310
(251) 990-7797
Mailing address
101 FLY CREEK AVE STE 301, FAIRHOPE, AL 36532-8310
(251) 990-7797
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3784
AL
Other
Enumeration date
11/22/2017
Last updated
11/22/2017
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