Provider Demographics
NPI:1003063058
Name:COTTAGE HILL DENTAL HEALTH CENTER PC
Entity Type:Organization
Organization Name:COTTAGE HILL DENTAL HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NORSTEDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-342-8484
Mailing Address - Street 1:1450 UNIVERSITY BLVD S
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-2947
Mailing Address - Country:US
Mailing Address - Phone:251-342-8484
Mailing Address - Fax:251-342-1561
Practice Address - Street 1:1450 UNIVERSITY BLVD S
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2947
Practice Address - Country:US
Practice Address - Phone:251-342-8484
Practice Address - Fax:251-342-1561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLNO 44551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty