Provider Demographics
NPI:1841008729
Name:AL PEDODONTICS, LLC
Entity type:Organization
Organization Name:AL PEDODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-914-4848
Mailing Address - Street 1:1618 KRISTI CIR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5832
Mailing Address - Country:US
Mailing Address - Phone:205-914-4848
Mailing Address - Fax:205-977-9888
Practice Address - Street 1:5500 1ST AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35212-2518
Practice Address - Country:US
Practice Address - Phone:205-977-9333
Practice Address - Fax:205-977-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty