Azalea City Dental, LLC

NPI #1053571364 in Chickasaw, Alabama

Provider Information

NPI Number: 1053571364
Entity Type: Organization
Organization Name: Azalea City Dental, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 10, 2008
Last Updated: Jun 10, 2008

Practice Location

Address: 457 N CRAFT HWY
City: Chickasaw
State: Alabama
ZIP Code: 36611-1364
Phone: (251) 456-8406

Authorized Official

Name: CINDY BLACK
Title: OFFICE MANAGER
Phone: (251) 456-8406

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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