| Daleville Dental, Llc | |
|
526 N Daleville Ave Daleville AL 36322-2000 | |
| (334) 598-4994 | |
| (334) 598-4342 |
| Full Name | Daleville Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 526 N Daleville Ave, Daleville, Alabama |
| Authorized Official Name and Position | Jay Michael Walters (OWNER) |
| Authorized Official Contact | 3345984994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daleville Dental, Llc 526 N Daleville Ave Daleville AL 36322-2000 Ph: (334) 598-4994 | Daleville Dental, Llc 526 N Daleville Ave Daleville AL 36322-2000 Ph: (334) 598-4994 |
| NPI Number | 1760477251 |
|---|---|
| Provider Enumeration Date | 09/12/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760477251 | NPI | - | NPPES |
| 820510 | Other | UCCI | |
| 51525448 | Other | AL | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4553 (Alabama) | Primary |
Daleville Dental Ii, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 526 N Daleville Ave, Daleville, AL 36322 Phone: 334-598-4994 |