Provider Demographics
NPI:1942627252
Name:RICK REDMOND FAMILY DENTISTRY INC.
Entity Type:Organization
Organization Name:RICK REDMOND FAMILY DENTISTRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:RICK
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-245-3645
Mailing Address - Street 1:PO BOX 1125
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-1125
Mailing Address - Country:US
Mailing Address - Phone:256-245-3645
Mailing Address - Fax:256-245-3218
Practice Address - Street 1:101 S DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2955
Practice Address - Country:US
Practice Address - Phone:256-245-3645
Practice Address - Fax:256-245-3218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4599261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental