Gardendale Oral Surgery, P.c.
NPI #1336632561 in Gardendale, Alabama
Provider Information
- NPI Number
- 1336632561
- Entity Type
- Organization
- Organization Name
- Gardendale Oral Surgery, P.c.
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Jun 12, 2018
- Last Updated
- Jul 5, 2018
Practice Location
- Address
- 919 SHARIT AVE STE 201
- City
- Gardendale
- State
- Alabama
- ZIP Code
- 35071
- Phone
- (205) 631-4004
Authorized Official
- Name
- JUSTIN D LACKEY
- Title
- FRONT OFFICE
- Phone
- (256) 595-2131
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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