Jasper Pediatric Dentistry, Llc in Jasper - Pediatric Dentistry
Jasper Pediatric Dentistry, Llc - NPI 1649303355
Jasper Pediatric Dentistry, Llc is a Pediatric Dentistry in Jasper, Alabama. Jasper Pediatric Dentistry, Llc practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Jasper Pediatric Dentistry, Llc is 1649303355. The last update date is 2020-08-22.
Jasper Pediatric Dentistry, Llc's current location address is 4330 Highway 78 E, Jasper, Alabama. You can contact this provider via phone number 2053849104 and fax number 2053849102. The mailing address for Jasper Pediatric Dentistry, Llc is 4330 Highway 78 E, Jasper, Alabama. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jasper Pediatric Dentistry, Llc |
|---|---|
| Address | 4330 Highway 78 E, Jasper, Alabama |
| Phone Number | 2053849104 |
| Fax Number | 2053849102 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | White Carol Katrina |
| Credentials | DMD |
| Telephone Number | 2053849104 |
NPI Number Detail
| NPI Number | 1649303355 |
|---|---|
| Provider Enumeration Date | 2007-03-13 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 4330 Highway 78 E |
|---|---|
| City | Jasper |
| State | Alabama (AL) |
| Post Code | 355018905 |
| Phone Number | 2053849104 |
| Fax Number | 2053849102 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 4967 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 51506630 | AL | BLUE CROSS |
Post Comment/ Review Below
What is the Jasper Pediatric Dentistry, Llc's 1649303355?
The Jasper Pediatric Dentistry, Llc's NPI (National Provider Identifier) Number is 1649303355. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Jasper Pediatric Dentistry, Llc?
The Jasper Pediatric Dentistry, Llc is physically situated at 4330 Highway 78 E, in the city of Jasper, state of AL, with the postal code 355018905.
What is the Jasper Pediatric Dentistry, Llc's specialty and taxonomy code?
The Jasper Pediatric Dentistry, Llc's specialty is Pediatric Dentistry, and the corresponding taxonomy code is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services issue the 1649303355 to Jasper Pediatric Dentistry, Llc?
The Jasper Pediatric Dentistry, Llc received its 1649303355 assignment from the Centers for Medicare & Medicaid Services on 2007-03-13.
When was the Jasper Pediatric Dentistry, Llc's information last updated?
The Jasper Pediatric Dentistry, Llc's information was last updated on 2020-08-22.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC