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581 Hughes Rd Madison AL 35758-8979 | |
| (256) 772-0041 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 581 Hughes Rd, Madison, Alabama |
| Authorized Official Name and Position | Matthew Gibson (MANAGING MEMBER) |
| Authorized Official Contact | 2567976135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
581 Hughes Rd Madison AL 35758-8979 Ph: (256) 772-0041 | 581 Hughes Rd Madison AL 35758-8979 Ph: (256) 772-0041 |
| NPI Number | 1194486522 |
|---|---|
| Provider Enumeration Date | 01/07/2022 |
| Last Update Date | 02/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194486522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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