| Magnolia Springs Dental, Llc | |
|
12440 Magnolia Ave Ste 200 Magnolia Springs AL 36555-6434 | |
| (251) 965-1773 | |
| Not Available |
| Full Name | Magnolia Springs Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12440 Magnolia Ave Ste 200, Magnolia Springs, Alabama |
| Authorized Official Name and Position | Matthew Roberto Pischek (OWNER) |
| Authorized Official Contact | 2512131101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Springs Dental, Llc 12440 Magnolia Ave Ste 200 Magnolia Springs AL 36555-6434 Ph: (251) 965-1773 | Magnolia Springs Dental, Llc 12440 Magnolia Ave Ste 200 Magnolia Springs AL 36555-6434 Ph: (251) 965-1773 |
| NPI Number | 1295457901 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 09/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295457901 | NPI | - | NPPES |
| 1861985483 | Other | AL | GENERAL DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |