Organization
SHOALS SMILE BY DESIGN PC
Active
Other names
Shoals Smile By Design
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBBIE L GALLOWAY (OFFICE MANAGER)
(256) 314-0676
Entity
Organization
Contact information
Practice address
301 W STATE ST, MUSCLE SHOALS, AL 35661-2835
(256) 314-0676
(256) 314-6373
Mailing address
PO BOX 3542, MUSCLE SHOALS, AL 35662-3542
(256) 314-0676
(256) 314-6373
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4664
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000764070
UNITED CONCORDIA
—
01
—
3140572
BCBS
TN
01
—
529903880
MEDICAID
AL
01
—
92836
BCBS
AL
Enumeration date
05/21/2008
Last updated
05/21/2008
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