Organization
SECD CHICKASAW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER BRITTANY MCDONALD (REGIONAL DIRECTOR)
(205) 434-7115
Entity
Organization
Contact information
Practice address
457 N CRAFT HWY, CHICKASAW, AL 36611-1364
(251) 456-8406
Mailing address
4320 MONTEVALLO RD, MOUNTAIN BRK, AL 35213-2722
(205) 434-7115
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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