| Bay Pediatric & Adolescent Dentistry | |
|
115 Lottie Ln Fairhope AL 36532-2995 | |
| (251) 928-5045 | |
| (251) 929-3335 |
| Full Name | Bay Pediatric & Adolescent Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 115 Lottie Ln, Fairhope, Alabama |
| Authorized Official Name and Position | William Wells Hammock (OWNER) |
| Authorized Official Contact | 2519285045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Pediatric & Adolescent Dentistry 115 Lottie Ln Fairhope AL 36532-2995 Ph: (251) 928-5045 | Bay Pediatric & Adolescent Dentistry 115 Lottie Ln Fairhope AL 36532-2995 Ph: (251) 928-5045 |
| NPI Number | 1609848308 |
|---|---|
| Provider Enumeration Date | 02/06/2006 |
| Last Update Date | 02/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609848308 | NPI | - | NPPES |
| 529923190 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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