| South Alabama Pediatric Dentistry Llc | |
|
801 University Blvd S Ste B Mobile AL 36609-2923 | |
| (251) 345-1717 | |
| (251) 343-0835 |
| Full Name | South Alabama Pediatric Dentistry Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 801 University Blvd S, Mobile, Alabama |
| Authorized Official Name and Position | Earl Gaines Thomas (OWNER) |
| Authorized Official Contact | 2513451717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Alabama Pediatric Dentistry Llc 801 University Blvd S Ste B Mobile AL 36609-2923 Ph: (251) 345-1717 | South Alabama Pediatric Dentistry Llc 801 University Blvd S Ste B Mobile AL 36609-2923 Ph: (251) 345-1717 |
| NPI Number | 1437289303 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 12/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437289303 | NPI | - | NPPES |
| 529912670 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 3282 (Alabama) | Primary |
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