Provider Demographics
NPI:1811452253
Name:ALABAMA DENTAL ASSOCIATES
Entity type:Organization
Organization Name:ALABAMA DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHERZHAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-956-8977
Mailing Address - Street 1:3920 GRANTS MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35210-1204
Mailing Address - Country:US
Mailing Address - Phone:205-956-8977
Mailing Address - Fax:205-956-8340
Practice Address - Street 1:3920 GRANTS MILL ROAD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35210-1204
Practice Address - Country:US
Practice Address - Phone:205-956-8977
Practice Address - Fax:205-956-8340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty