Organization
BRENT DENTAL CARE
Active
Parent organization
MOON ROAD COSMETIC & FAMILY DENTISTRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOON ROAD COSMETIC & FAMILY DENTISTRY
Authorized official
DR. DAYO OBEBE DMD (DIRECTOR)
(205) 936-2151
Entity
Organization
Contact information
Practice address
2939 MAIN ST, BOX 960, BRENT, AL 35034-4000
(205) 926-1901
Mailing address
2939 MAIN ST, P.O. BOX 960, BRENT, AL 35034-4000
(205) 926-1901
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AL 4726
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529926460
—
AL
Enumeration date
09/14/2006
Last updated
09/12/2007
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