Provider Demographics
NPI:1841383809
Name:WARRIOR FAMILY DENTISTRY
Entity Type:Organization
Organization Name:WARRIOR FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDMUNDSON
Authorized Official - Last Name:HAMRIC
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-647-6647
Mailing Address - Street 1:211 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180
Mailing Address - Country:US
Mailing Address - Phone:205-647-3181
Mailing Address - Fax:205-647-1134
Practice Address - Street 1:211 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180
Practice Address - Country:US
Practice Address - Phone:205-647-3181
Practice Address - Fax:205-647-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty