| Heritage Dental Group Usa.llc | |
|
740 Hillcrest Rd Ste 2b Mobile AL 36695-4021 | |
| (251) 639-0911 | |
| (251) 633-7889 |
| Full Name | Heritage Dental Group Usa.llc |
|---|---|
| Speciality | Dentist |
| Location | 740 Hillcrest Rd Ste 2b, Mobile, Alabama |
| Authorized Official Name and Position | Shyrl L Johnson (OFFICE MANAGER) |
| Authorized Official Contact | 2516390911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Dental Group Usa.llc 740 Hillcrest Rd Ste 2b Mobile AL 36695-4021 Ph: (251) 639-0911 | Heritage Dental Group Usa.llc 740 Hillcrest Rd Ste 2b Mobile AL 36695-4021 Ph: (251) 639-0911 |
| NPI Number | 1801252473 |
|---|---|
| Provider Enumeration Date | 01/12/2016 |
| Last Update Date | 01/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801252473 | NPI | - | NPPES |
| 165097 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4049 (Alabama) | Primary |
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