Organization
MOBILE COUNTY BOARD OF HEALTH
Active
Other names
Citronelle Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WARREN (EXECUTIVE DIRECTOR)
(251) 690-8158
Entity
Organization
Contact information
Practice address
19260 N MOBILE ST, CITRONELLE, AL 36522-2122
(251) 866-5585
(251) 866-9121
Mailing address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186546
—
AL
Enumeration date
05/05/2016
Last updated
04/29/2021
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