Organization
ALABAMA DENTAL PROFESSIONALS PC
Active
Parent organization
ALABAMA DENTAL PROFESSIONALS PC
Other names
Broad Street Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALABAMA DENTAL PROFESSIONALS PC
Authorized official
KIM ZUBER (CRED SUP)
(217) 540-5170
Entity
Organization
Contact information
Practice address
1202 S BROAD ST, SCOTTSBORO, AL 35768-2512
(256) 259-5955
(256) 259-5954
Mailing address
1202 S BROAD ST, SCOTTSBORO, AL 35768-2512
(256) 259-5955
(256) 259-5954
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4762
AL
332BC3200X
Customized Equipment (DME)
4762
AL
Other
Enumeration date
01/27/2011
Last updated
11/08/2019
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