| Fairhope Cosmetic Dentistry And Fresh Beath Center | |
|
101 Fly Creek Avenue Suite 301 Fairhope AL 36532 | |
| (251) 990-7797 | |
| (251) 990-7769 |
| Full Name | Fairhope Cosmetic Dentistry And Fresh Beath Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 Fly Creek Avenue, Fairhope, Alabama |
| Authorized Official Name and Position | James M. Clark (OWNER) |
| Authorized Official Contact | 2519907797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairhope Cosmetic Dentistry And Fresh Beath Center 7540 Cipriano Ct Fairhope AL 36532-3029 Ph: (251) 990-7797 | Fairhope Cosmetic Dentistry And Fresh Beath Center 101 Fly Creek Avenue Suite 301 Fairhope AL 36532 Ph: (251) 990-7797 |
| NPI Number | 1235435785 |
|---|---|
| Provider Enumeration Date | 02/01/2011 |
| Last Update Date | 05/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235435785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | AL3834 (Alabama) | Primary |
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