Provider Demographics
NPI:1629549811
Name:NEW BEGINNINGS DENTAL LLC
Entity type:Organization
Organization Name:NEW BEGINNINGS DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:GABRIELLA
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:BIANCALANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-217-1238
Mailing Address - Street 1:2481 PINNACLE WAY
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-6543
Mailing Address - Country:US
Mailing Address - Phone:630-779-7400
Mailing Address - Fax:
Practice Address - Street 1:2481 PINNACLE WAY
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-6543
Practice Address - Country:US
Practice Address - Phone:630-779-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty