| Pine Belt Dental Llc | |
|
297c S Jackson St Grove Hill AL 36451-3231 | |
| (251) 275-3822 | |
| (251) 275-4190 |
| Full Name | Pine Belt Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 297c S Jackson St, Grove Hill, Alabama |
| Authorized Official Name and Position | Jimmy C White (GENERAL PARTNER) |
| Authorized Official Contact | 2512753822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Belt Dental Llc 297c S Jackson St P O Box 129 Grove Hill AL 36451-3231 Ph: (251) 275-3822 | Pine Belt Dental Llc 297c S Jackson St Grove Hill AL 36451-3231 Ph: (251) 275-3822 |
| NPI Number | 1144588906 |
|---|---|
| Provider Enumeration Date | 04/30/2012 |
| Last Update Date | 04/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144588906 | NPI | - | NPPES |
| 1962737916 | Other | AL | NATIONAL PROVIDER IDENTIFIER |
| 1558445999 | Other | AL | NATIONAL PROVIDER IDENTIFIER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | AL3287 (Alabama) | Primary |
The Grove Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 297c S Jackson St, Grove Hill, AL 36451 Phone: 251-275-3822 |