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810 Palmer Plaza # 103 Madison AL 35758 | |
| (256) 772-2626 | |
| (256) 772-2602 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 810 Palmer Plaza, Madison, Alabama |
| Authorized Official Name and Position | Terry A Burgess (DENTIST/OWNER) |
| Authorized Official Contact | 2567722626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
810 Palmer Plaza # 103 Madison AL 35758 Ph: (256) 772-2626 | 810 Palmer Plaza # 103 Madison AL 35758 Ph: (256) 772-2626 |
| NPI Number | 1649648858 |
|---|---|
| Provider Enumeration Date | 09/03/2015 |
| Last Update Date | 06/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649648858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4219 (Alabama) | Primary |
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