| Mark E. Love Dmd ,pc | |
|
510 Engle Dr Se Russellville AL 35653-2749 | |
| (256) 332-6073 | |
| (256) 332-6655 |
| Full Name | Mark E. Love Dmd ,pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 510 Engle Dr Se, Russellville, Alabama |
| Authorized Official Name and Position | Mark Edwin Love (DENTIST) |
| Authorized Official Contact | 2563326073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark E. Love Dmd ,pc 510 Engle Dr Se Russellville AL 35653-2749 Ph: (256) 332-6073 | Mark E. Love Dmd ,pc 510 Engle Dr Se Russellville AL 35653-2749 Ph: (256) 332-6073 |
| NPI Number | 1063928653 |
|---|---|
| Provider Enumeration Date | 12/19/2017 |
| Last Update Date | 12/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063928653 | NPI | - | NPPES |
| 63-11104550 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3951 (Alabama) | Primary |
Rousseau Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Engle Dr Se, Russellville, AL 35653 Phone: 256-332-6073 Fax: 256-332-6655 | |
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