| Hickory Hills Dental Care Llc | |
|
1947 Florence Blvd Florence AL 35630-2729 | |
| (256) 766-8800 | |
| (256) 766-8936 |
| Full Name | Hickory Hills Dental Care Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1947 Florence Blvd, Florence, Alabama |
| Authorized Official Name and Position | Ian Kyle Fawcett (OWNER) |
| Authorized Official Contact | 2567668800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hickory Hills Dental Care Llc 1947 Florence Blvd Florence AL 35630-2729 Ph: (256) 766-8800 | Hickory Hills Dental Care Llc 1947 Florence Blvd Florence AL 35630-2729 Ph: (256) 766-8800 |
| NPI Number | 1205301777 |
|---|---|
| Provider Enumeration Date | 10/10/2018 |
| Last Update Date | 10/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205301777 | NPI | - | NPPES |
| 207491 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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