| Oneonta Dental Center | |
|
28425 State Highway 75 Oneonta AL 35121-1657 | |
| (205) 625-4384 | |
| (205) 625-4737 |
| Full Name | Oneonta Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 28425 State Highway 75, Oneonta, Alabama |
| Authorized Official Name and Position | Bridgette Marie Blackwood (OFFICE MANAGER) |
| Authorized Official Contact | 2056254384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oneonta Dental Center 28425 State Highway 75 Oneonta AL 35121-1657 Ph: (205) 625-4384 | Oneonta Dental Center 28425 State Highway 75 Oneonta AL 35121-1657 Ph: (205) 625-4384 |
| NPI Number | 1760506141 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 03/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760506141 | NPI | - | NPPES |
| 51077759 | Other | AL | BLUE CROSS PROVIDER # |
| 529916600 | Medicaid | AL | |
| 353978 | Other | COMPBEN ID | |
| 577227 | Other | UNITED CONCORDIA PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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