| Mobile Bay Dental Llc | |
|
301 Saint Joseph St Mobile AL 36602-4037 | |
| (251) 433-7717 | |
| (251) 433-9384 |
| Full Name | Mobile Bay Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 301 Saint Joseph St, Mobile, Alabama |
| Authorized Official Name and Position | Lance Christopher Hankinson (DENTIST) |
| Authorized Official Contact | 2514337717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Bay Dental Llc 301 Saint Joseph St Mobile AL 36602-4037 Ph: (251) 433-7717 | Mobile Bay Dental Llc 301 Saint Joseph St Mobile AL 36602-4037 Ph: (251) 433-7717 |
| NPI Number | 1922193002 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/01/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922193002 | NPI | - | NPPES |
| 529912860 | Medicaid | AL | |
| 14048 | Other | AL | BCBS OF ALABAMA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5226 (Alabama) | Primary |
| 152W00000X | Optometrist | S-779-TA-178 (Alabama) | Secondary |
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