| Alexandra Dental Llc | |
|
654 Valley Cub Dr Alexandria AL 36250-4200 | |
| (256) 847-1111 | |
| Not Available |
| Full Name | Alexandra Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 654 Valley Cub Dr, Alexandria, Alabama |
| Authorized Official Name and Position | Brant Haynie (DENTIST) |
| Authorized Official Contact | 2054670387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexandra Dental Llc 654 Valley Cub Dr Alexandria AL 36250-4200 Ph: () - | Alexandra Dental Llc 654 Valley Cub Dr Alexandria AL 36250-4200 Ph: (256) 847-1111 |
| NPI Number | 1194227090 |
|---|---|
| Provider Enumeration Date | 03/06/2018 |
| Last Update Date | 03/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194227090 | NPI | - | NPPES |
| 171653 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Alabama) | Primary |
Hartzog Dental, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 654 Valley Cub Dr, Alexandria, AL 36250 Phone: 256-847-1111 |