Provider Demographics
NPI:1376004002
Name:DENTAL ASSOCIATES OF JONES VALLEY LLC
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF JONES VALLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:S
Authorized Official - Last Name:WRENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-353-5600
Mailing Address - Street 1:2124 CECIL ASHBURN DR SE STE 130
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2575
Mailing Address - Country:US
Mailing Address - Phone:256-429-9220
Mailing Address - Fax:256-429-9484
Practice Address - Street 1:2124 CECIL ASHBURN DR SE STE 130
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2575
Practice Address - Country:US
Practice Address - Phone:256-429-9220
Practice Address - Fax:256-429-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty