Southside Family & Cosmetic Dentistry, LLC

NPI #1346583457 in Southside, Alabama

Provider Information

NPI Number: 1346583457
Entity Type: Organization
Organization Name: Southside Family & Cosmetic Dentistry, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 27, 2013
Last Updated: Mar 27, 2013

Practice Location

Address: 1745 HIGHWAY 77
City: Southside
State: Alabama
ZIP Code: 35907-0169
Phone: (256) 442-1463

Authorized Official

Name: DONNA JENNINGS
Title: OFFICE MANAGER
Phone: (256) 442-1463

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X
Dental Assistant	126800000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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