| Advantage Dental Oral Health And Vision Center Of Alabama, P.c. | |
|
215c Industrial Blvd Leesburg AL 35983-3742 | |
| (256) 526-7601 | |
| (256) 526-7603 |
| Full Name | Advantage Dental Oral Health And Vision Center Of Alabama, P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 215c Industrial Blvd, Leesburg, Alabama |
| Authorized Official Name and Position | Sherrie Edmondson (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 6299995014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Dental Oral Health And Vision Center Of Alabama, P.c. Po Box 411714 Boston MA 02241-6805 Ph: (629) 999-5014 | Advantage Dental Oral Health And Vision Center Of Alabama, P.c. 215c Industrial Blvd Leesburg AL 35983-3742 Ph: (256) 526-7601 |
| NPI Number | 1003046772 |
|---|---|
| Provider Enumeration Date | 07/16/2009 |
| Last Update Date | 03/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003046772 | NPI | - | NPPES |
| 112230 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |