Provider Demographics
NPI:1437345477
Name:ALABAMA SMILES
Entity Type:Organization
Organization Name:ALABAMA SMILES
Other - Org Name:THE TOOTH ZONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:PORCO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:334-495-2243
Mailing Address - Street 1:755 E SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2305
Mailing Address - Country:US
Mailing Address - Phone:334-495-2243
Mailing Address - Fax:334-495-2244
Practice Address - Street 1:755 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2305
Practice Address - Country:US
Practice Address - Phone:334-495-2243
Practice Address - Fax:334-495-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty