Advantage Dental Oral Health and Vision Center of Alabama, P.C.

Organization Active NPI Pediatric Dentistry · Dothan, AL

NPI 1811301385 · NPPES record last updated Dec 30, 2021

Key facts

NPI
1811301385
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Dentistry 1223P0221X
Legal business name
ADVANTAGE DENTAL ORAL HEALTH AND VISION CENTER OF ALABAMA, P.C.
Practice address
5412 Montgomery Hwy Ste 8
Dothan, AL 36303-1657
Phone
(334) 983-1730
Fax
(334) 983-1725
NPI assigned
Jun 12, 2014
Organization subpart
No

Authorized official

Name
Sherrie Edmondson
Title
Manager, Licensing & Credentialing
Phone
(629) 999-5014

Corporate family (same tax ID) 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Advantage Dental Oral Health and Vision Center of Alabama PC (31 organizations share this tax ID)

Locations

5412 Montgomery Hwy
Dothan, AL 36303
Phone (334) 983-1730

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223P0221X Yes

Addresses

Primary practice location

5412 Montgomery Hwy Ste 8
Dothan, AL 36303-1657

Mailing address

3322 W End Ave Ste 400
Nashville, TN 37203-6805
Phone (629) 999-5014

Other identifiers

IdentifierTypeStateIssuer
161859MedicaidAL

Other providers in Dothan, AL

All providers in Dothan, AL · Pediatric Dentistry in Alabama

Sources for this page

Verify at the official NPI Registry.