Organization
PEDIATRIC DENTAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD B CHAMBLISS JR. DMD (PRESIDENT)
(205) 338-4227
Entity
Organization
Contact information
Practice address
2806 DR JOHN HAYNES DR STE B, PELL CITY, AL 35125-1485
(205) 338-4227
(205) 338-4204
Mailing address
2806 DR JOHN HAYNES DR STE B, PELL CITY, AL 35125-1485
(205) 338-4227
(205) 338-4204
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
LNO5181
AL
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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