| Tooth Buds At Lagoon Park, Llc | |
|
553 N Eastern Blvd Montgomery AL 36117-2213 | |
| (334) 801-9800 | |
| (334) 801-9848 |
| Full Name | Tooth Buds At Lagoon Park, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 553 N Eastern Blvd, Montgomery, Alabama |
| Authorized Official Name and Position | J. David Stanley (MEMBER/OWNER) |
| Authorized Official Contact | 3348019800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooth Buds At Lagoon Park, Llc 553 N Eastern Blvd Montgomery AL 36117-2213 Ph: (334) 801-9800 | Tooth Buds At Lagoon Park, Llc 553 N Eastern Blvd Montgomery AL 36117-2213 Ph: (334) 801-9800 |
| NPI Number | 1114392107 |
|---|---|
| Provider Enumeration Date | 12/02/2015 |
| Last Update Date | 02/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114392107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5221 (Alabama) | Primary |
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