Provider Demographics
NPI:1659623338
Name:DENTON DENTAL PC
Entity Type:Organization
Organization Name:DENTON DENTAL PC
Other - Org Name:SAVE-ON DENTAL CARE OF ARAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KC
Authorized Official - Middle Name:
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-295-0230
Mailing Address - Street 1:PO BOX 1236
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36533-1236
Mailing Address - Country:US
Mailing Address - Phone:256-586-3117
Mailing Address - Fax:
Practice Address - Street 1:1178 N BRINDLEE MTN PKWY
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1063
Practice Address - Country:US
Practice Address - Phone:251-295-0230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty