Organization
PEDIATRIC DENTISTRY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH K CARROLL (CORPORATE SECRETARY)
(334) 745-6443
Entity
Organization
Contact information
Practice address
121 N 20TH ST, SUITE 20-C, OPELIKA, AL 36801-5449
(334) 745-6443
(334) 745-3444
Mailing address
121 N 20TH ST, SUITE 20-C, OPELIKA, AL 36801-5449
(334) 745-6443
(334) 745-3444
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3156
AL
Other
Enumeration date
03/21/2007
Last updated
08/22/2020
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