| Fresh Wave Dental Care | |
|
812 Boll Weevil Cir Enterprise AL 36330-2079 | |
| (334) 347-9283 | |
| Not Available |
| Full Name | Fresh Wave Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 812 Boll Weevil Cir, Enterprise, Alabama |
| Authorized Official Name and Position | Debbielee J Hawn (OFFICE MANGER) |
| Authorized Official Contact | 3343479283 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Wave Dental Care 812 Boll Weevil Cir Enterprise AL 36330-2079 Ph: (334) 347-9283 | Fresh Wave Dental Care 812 Boll Weevil Cir Enterprise AL 36330-2079 Ph: (334) 347-9283 |
| NPI Number | 1134392517 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134392517 | NPI | - | NPPES |
| 51027316 | Other | AL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4810 (Alabama) | Primary |
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