1982994653 NPI number — E.N.R. DENTAL P.C.

Table of content: (NPI 1982994653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982994653 NPI number — E.N.R. DENTAL P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
E.N.R. DENTAL P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
U SAVE DENTISTRY OF FOLEY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982994653
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
732 MONTGOMERY HWY
Provider Second Line Business Mailing Address:
PMB 102
Provider Business Mailing Address City Name:
VESTAVIA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35216-1800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-478-3996
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1121 S MCKENZIE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOLEY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36535-1816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-970-2333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DUTTON
Authorized Official First Name:
CAREY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
205-478-3996

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  AL2415 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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