| Burntshirt Llc | |
|
3525 Young Meadows Rd Montgomery AL 36116-1114 | |
| (334) 277-2332 | |
| Not Available |
| Full Name | Burntshirt Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3525 Young Meadows Rd, Montgomery, Alabama |
| Authorized Official Name and Position | Samantha Freeman Rolen (OWNER) |
| Authorized Official Contact | 3342772332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Burntshirt Llc 3525 Young Meadows Rd Montgomery AL 36116-1114 Ph: (334) 277-2332 | Burntshirt Llc 3525 Young Meadows Rd Montgomery AL 36116-1114 Ph: (334) 277-2332 |
| NPI Number | 1023976560 |
|---|---|
| Provider Enumeration Date | 01/13/2026 |
| Last Update Date | 01/13/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023976560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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