Provider Demographics
NPI:1700206703
Name:FRANKLIN PRIMARY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:FRANKLIN PRIMARY HEALTH CENTER, INC.
Other - Org Name:BREWTON FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-432-4117
Mailing Address - Street 1:1303 DR MARTIN L KING JR AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36603-5341
Mailing Address - Country:US
Mailing Address - Phone:251-432-4117
Mailing Address - Fax:251-436-7765
Practice Address - Street 1:1115 AZALEA PL
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1318
Practice Address - Country:US
Practice Address - Phone:251-867-8020
Practice Address - Fax:251-867-8079
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANKLIN PRIMARY HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-17
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty