Organization
PREMIERE DENTAL SPA AT MADISON
Active
Parent organization
PREMIERE DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIERE DENTAL
Authorized official
DR. TENESHIA EARLINE DANIELS DDS (OWNER)
(256) 469-6428
Entity
Organization
Contact information
Practice address
102 ST LOUIS ST STE D, MADISON, AL 35758-8028
(256) 469-6428
Mailing address
102 ST LOUIS ST STE D, MADISON, AL 35758-8028
(256) 469-6428
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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