Organization
MARK TICKLE FAMILY AND IMPLANT DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK TICKLE DMD (OWNER)
(205) 758-0200
Entity
Organization
Contact information
Practice address
601 HARGROVE RD E, SUITE B, TUSCALOOSA, AL 35401-3792
(205) 758-0200
Mailing address
601 HARGROVE RD E, SUITE B, TUSCALOOSA, AL 35401-3792
(205) 758-0200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5706
AL
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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