Provider Demographics
NPI:1295393106
Name:AC DENTISTRY
Entity Type:Organization
Organization Name:AC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-533-6799
Mailing Address - Street 1:7350 CAHABA VALLEY RD STE 106
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6318
Mailing Address - Country:US
Mailing Address - Phone:205-533-6799
Mailing Address - Fax:205-588-0874
Practice Address - Street 1:7350 CAHABA VALLEY RD STE 106
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6318
Practice Address - Country:US
Practice Address - Phone:205-533-6799
Practice Address - Fax:205-588-0874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1770935876OtherNPI