| Southeast Dental | |
|
1865 E. Main St. Suite #2 Dothan AL 36301-3630 | |
| (302) 332-5375 | |
| Not Available |
| Full Name | Southeast Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1865 E. Main St. Suite #2, Dothan, Alabama |
| Authorized Official Name and Position | Roth Rube Harrison Lewis (OWNER) |
| Authorized Official Contact | 3023325375 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Dental 220 N Park Ave Dothan AL 36303-4016 Ph: (302) 332-5375 | Southeast Dental 1865 E. Main St. Suite #2 Dothan AL 36301-3630 Ph: (302) 332-5375 |
| NPI Number | 1245868827 |
|---|---|
| Provider Enumeration Date | 03/30/2020 |
| Last Update Date | 03/30/2020 |
| Certification Date | 03/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245868827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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