| Lakeside Dental - Tuscaloosa | |
|
5520 Rice Mine Rd Ne Tuscaloosa AL 35406-2665 | |
| (205) 343-9393 | |
| Not Available |
| Full Name | Lakeside Dental - Tuscaloosa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5520 Rice Mine Rd Ne, Tuscaloosa, Alabama |
| Authorized Official Name and Position | Tabatha Lemke (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175406078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Dental - Tuscaloosa 5520 Rice Mine Rd Ne Tuscaloosa AL 35406-2665 Ph: (205) 343-9393 | Lakeside Dental - Tuscaloosa 5520 Rice Mine Rd Ne Tuscaloosa AL 35406-2665 Ph: (205) 343-9393 |
| NPI Number | 1073119608 |
|---|---|
| Provider Enumeration Date | 12/09/2020 |
| Last Update Date | 10/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073119608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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