| North Jefferson Pediatric Dentistry, Llc | |
|
925 Sharit Ave Stuite 113 Gardendale AL 35071-5000 | |
| (205) 631-2240 | |
| (205) 631-1611 |
| Full Name | North Jefferson Pediatric Dentistry, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 925 Sharit Ave, Gardendale, Alabama |
| Authorized Official Name and Position | Selena D Devine (OFFICE MANAGER) |
| Authorized Official Contact | 2056312240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Jefferson Pediatric Dentistry, Llc 925 Sharit Ave Stuite 113 Gardendale AL 35071-5000 Ph: (205) 631-2240 | North Jefferson Pediatric Dentistry, Llc 925 Sharit Ave Stuite 113 Gardendale AL 35071-5000 Ph: (205) 631-2240 |
| NPI Number | 1043351950 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043351950 | NPI | - | NPPES |
| 1356891 | Other | AL | UCCI |
| 51531288 | Other | AL | BCBS OF ALABAMA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4970 (Alabama) | Primary |
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