Organization
MATTHEW TICOLA DMD LLC
Active
Other names
Little Critters Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW TICOLA (MANAGER)
(256) 505-8954
Entity
Organization
Contact information
Practice address
11521 US HIGHWAY 431 STE V, GUNTERSVILLE, AL 35976-5671
(256) 505-8954
Mailing address
11521 US HIGHWAY 431 STE V, GUNTERSVILLE, AL 35976-5671
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D0005747-C
AL
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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