Organization
STONECREEK DENTAL OF ALABAMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA JACKSON (REVENUE CYCLE MANAGER)
(205) 538-5464
Entity
Organization
Contact information
Practice address
1901 MULBERRY ST, MONTGOMERY, AL 36106-1626
(334) 265-9202
Mailing address
1901 MULBERRY ST, MONTGOMERY, AL 36106-1626
(334) 265-9202
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
NONE
—
Enumeration date
01/06/2022
Last updated
01/06/2022
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