Provider Demographics
NPI:1437694122
Name:ALABAMA SLEEP AND MIGRAINE SOLUTIONS LLC
Entity Type:Organization
Organization Name:ALABAMA SLEEP AND MIGRAINE SOLUTIONS LLC
Other - Org Name:SHOALS SMILE BY DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-314-0676
Mailing Address - Street 1:301 W STATE ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2835
Mailing Address - Country:US
Mailing Address - Phone:256-314-0676
Mailing Address - Fax:256-314-6373
Practice Address - Street 1:301 W STATE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2835
Practice Address - Country:US
Practice Address - Phone:256-314-0676
Practice Address - Fax:256-314-6373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD. 46641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty