Organization
ADVANTAGE DENTAL ORAL HEALTH AND VISION CENTER OF ALABAMA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRIE EDMONDSON (MANAGER, LICENSING & CREDENTIALING)
(629) 999-5014
Entity
Organization
Contact information
Practice address
310 W ELM ST, ATHENS, AL 35611-4802
(256) 262-0200
(256) 262-0201
Mailing address
3322 W END AVE STE 400, NASHVILLE, TN 37203-6805
(629) 999-5014
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115249
—
AL
Enumeration date
12/11/2009
Last updated
12/30/2021
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