| North Alabama Oral And Facial Surgery Llc | |
|
44 Hughes Rd Madison AL 35758-3045 | |
| (256) 774-3535 | |
| (256) 325-6145 |
| Full Name | North Alabama Oral And Facial Surgery Llc |
|---|---|
| Speciality | Dentist |
| Location | 44 Hughes Rd, Madison, Alabama |
| Authorized Official Name and Position | Jason R Miller (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2562654950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Alabama Oral And Facial Surgery Llc 44 Hughes Rd Madison AL 35758-3045 Ph: (256) 774-3535 | North Alabama Oral And Facial Surgery Llc 44 Hughes Rd Madison AL 35758-3045 Ph: (256) 774-3535 |
| NPI Number | 1700273208 |
|---|---|
| Provider Enumeration Date | 04/22/2015 |
| Last Update Date | 04/22/2015 |
| Medicare PECOS PAC ID | 7113231150 |
|---|---|
| Medicare Enrollment ID | O20150804004468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700273208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 25550 (Alabama) | Primary |
| Provider Name | Jonathan M.c. Threadgill |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1093881021 PECOS PAC ID: 3779749361 Enrollment ID: I20160516000616 |
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