Alabama Dental Professionals PC

NPI #1639552284 in Fairhope, Alabama

Provider Information

NPI Number: 1639552284
Entity Type: Organization
Organization Name: Alabama Dental Professionals PC
Subpart: Yes (part of a larger organization)
Parent Organization: ALABAMA DENTAL PROFESSIONALS PC
Primary Specialty: Dentist
Enumeration Date: Jul 1, 2015
Last Updated: Jul 1, 2015

Practice Location

Address: 19354 GREENO RD
City: Fairhope
State: Alabama
ZIP Code: 36532-3834
Phone: (251) 990-8885

Authorized Official

Name: JASMINE REARDON
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-8330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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