| Ld-northport, Llc | |
|
1100 Fairfax Park Tuscaloosa AL 35406-2809 | |
| (205) 752-3506 | |
| (205) 752-3570 |
| Full Name | Ld-northport, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1100 Fairfax Park, Tuscaloosa, Alabama |
| Authorized Official Name and Position | Lauren S Daigneault (ADMIN DIRECTOR) |
| Authorized Official Contact | 2567839468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ld-northport, Llc 1100 Fairfax Park Tuscaloosa AL 35406-2809 Ph: (205) 752-3506 | Ld-northport, Llc 1100 Fairfax Park Tuscaloosa AL 35406-2809 Ph: (205) 752-3506 |
| NPI Number | 1114634730 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 07/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114634730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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