| Dentistry For Awesome Kids | |
|
623 8th Ave W Birmingham AL 35204-3604 | |
| (334) 505-0891 | |
| Not Available |
| Full Name | Dentistry For Awesome Kids |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 623 8th Ave W, Birmingham, Alabama |
| Authorized Official Name and Position | Lauten Johnson (GENERAL DENTIST) |
| Authorized Official Contact | 2054470202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentistry For Awesome Kids 623 8th Ave W Birmingham AL 35204-3604 Ph: (334) 505-0891 | Dentistry For Awesome Kids 623 8th Ave W Birmingham AL 35204-3604 Ph: (334) 505-0891 |
| NPI Number | 1124565676 |
|---|---|
| Provider Enumeration Date | 01/23/2017 |
| Last Update Date | 01/23/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124565676 | NPI | - | NPPES |
| 1114368800 | Medicaid | AL | |
| 1992970545 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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