Organization
NASSETTA PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK CONRAD NASSETTA DMD (PRESIDENT)
(205) 586-5806
Entity
Organization
Contact information
Practice address
1705 MAIN AVE SW, SUITE A, CULLMAN, AL 35055-7206
(256) 739-6000
Mailing address
1705 MAIN AVE SW, SUITE A, CULLMAN, AL 35055-7206
(256) 739-6000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5294
AL
Other
Enumeration date
05/26/2008
Last updated
05/26/2008
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