| Citronelle Dental Clinic | |
|
19260 N Mobile St Citronelle AL 36522-2122 | |
| (251) 866-5585 | |
| (251) 866-9121 |
| Full Name | Citronelle Dental Clinic |
|---|---|
| Speciality | Clinic/center - Public Health, State Or Local |
| Location | 19260 N Mobile St, Citronelle, Alabama |
| Authorized Official Name and Position | Kelly Warren (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2516908158 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Citronelle Dental Clinic 251 N Bayou St Mobile AL 36603-5827 Ph: (251) 690-8158 | Citronelle Dental Clinic 19260 N Mobile St Citronelle AL 36522-2122 Ph: (251) 866-5585 |
| NPI Number | 1578919890 |
|---|---|
| Provider Enumeration Date | 05/05/2016 |
| Last Update Date | 04/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578919890 | NPI | - | NPPES |
| 186546 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (Alabama) | Primary |
Citronelle Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19250 N Mobile St, Citronelle, AL 36522 Phone: 251-866-9129 Fax: 251-866-9121 | |
Gmuc Of Citronelle Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19355 N 3rd St, Suite 104, Citronelle, AL 36522 Phone: 251-633-0123 Fax: 251-445-3722 | |
Providence Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19140 S 3rd St, Citronelle, AL 36522 Phone: 251-866-0086 Fax: 251-866-0089 | |
Providence Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19140 S 3rd St, Citronelle, AL 36522 Phone: 251-866-0086 Fax: 251-866-0089 |