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Organization

CYPRESS CREEK DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIA KENNEDY D.M.D. (OWNER)
(256) 766-2606
Entity
Organization

Contact information

Practice address
3500 CLOVERDALE RD, FLORENCE, AL 35633-1302
(256) 766-2606
(256) 764-8502
Mailing address
3500 CLOVERDALE RD, FLORENCE, AL 35633-1302

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5854
AL

Other

Enumeration date
02/07/2013
Last updated
02/07/2013
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