Srd Athens, Pllc

NPI #1053029116 in Athens, Alabama

Provider Information

NPI Number: 1053029116
Entity Type: Organization
Organization Name: Srd Athens, Pllc
Primary Specialty: Dentist
Enumeration Date: Nov 8, 2022
Last Updated: Nov 22, 2022

Practice Location

Address: 22026 GATEWAY BLVD
Address 2: SUITES A
City: Athens
State: Alabama
ZIP Code: 35613
Phone: (256) 383-8037

Authorized Official

Name: CHRISTYN SHIELDS
Title: CONTROLLER
Phone: (256) 320-5903

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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