| Geneva Family Dentistry, Llc | |
|
100 W Lake Professional Park Suite 5 Geneva AL 36340-1203 | |
| (334) 805-3975 | |
| Not Available |
| Full Name | Geneva Family Dentistry, Llc |
|---|---|
| Speciality | Dentist |
| Location | 100 W Lake Professional Park, Geneva, Alabama |
| Authorized Official Name and Position | Jonathan David Markham (SOLE MEMBER-OWNER) |
| Authorized Official Contact | 3348053975 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Geneva Family Dentistry, Llc 100 W Lake Professional Park Suite 5 Geneva AL 36340-1203 Ph: (334) 805-3975 | Geneva Family Dentistry, Llc 100 W Lake Professional Park Suite 5 Geneva AL 36340-1203 Ph: (334) 805-3975 |
| NPI Number | 1972863348 |
|---|---|
| Provider Enumeration Date | 05/20/2012 |
| Last Update Date | 05/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972863348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5826 (Alabama) | Primary |
Thomas W. Parish Jr. Dmd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 706 W. Maple Ave, Geneva, AL 36340 Phone: 334-684-3096 Fax: 334-684-2828 |