Provider Demographics
NPI:1730459538
Name:DR. TREY'S CHILDREN'S DENTISTRY
Entity Type:Organization
Organization Name:DR. TREY'S CHILDREN'S DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:HOKE
Authorized Official - Last Name:FELLERS
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:251-928-3030
Mailing Address - Street 1:303 N SECTION ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-2634
Mailing Address - Country:US
Mailing Address - Phone:251-928-3030
Mailing Address - Fax:251-928-2455
Practice Address - Street 1:24208 US HIGHWAY 98
Practice Address - Street 2:SUITE C
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3466
Practice Address - Country:US
Practice Address - Phone:251-928-3030
Practice Address - Fax:251-928-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL52921223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty