Provider Demographics
NPI:1780779843
Name:RENE' A. TALBOT, DDS, P.C.
Entity type:Organization
Organization Name:RENE' A. TALBOT, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:ALANE
Authorized Official - Last Name:TALBOT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:256-533-0140
Mailing Address - Street 1:915 BOB WALLACE AVENUE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-533-0140
Mailing Address - Fax:256-533-0818
Practice Address - Street 1:915 BOB WALLACE AVENUE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-533-0140
Practice Address - Fax:256-533-0818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
586403OtherUNITED CONCORDIA
AL20587OtherBCBS OF AL
AL46088OtherBCBS OF AL
TN4099028OtherBCBS OF TENNESSEE
819668OtherUNITED CONCORDIA