| Locust Fork Family Dentistry, Inc. | |
|
29984 State Highway 79 Ste 300 Locust Fork AL 35097-5877 | |
| (205) 681-3050 | |
| (844) 815-6428 |
| Full Name | Locust Fork Family Dentistry, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 29984 State Highway 79 Ste 300, Locust Fork, Alabama |
| Authorized Official Name and Position | Rachel G Osborne (OWNER/OPERATOR) |
| Authorized Official Contact | 2056813050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Locust Fork Family Dentistry, Inc. 29984 State Highway 79 Ste 300 Locust Fork AL 35097-5877 Ph: (205) 681-3050 | Locust Fork Family Dentistry, Inc. 29984 State Highway 79 Ste 300 Locust Fork AL 35097-5877 Ph: (205) 681-3050 |
| NPI Number | 1386158293 |
|---|---|
| Provider Enumeration Date | 11/30/2017 |
| Last Update Date | 11/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386158293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5624 (Alabama) | Primary |