| Organization Name: | SARRELL REGIONAL DENTAL CENTER FOR PUBLIC HEALTH, INC. |
| NPI Number: | 1245530161 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARLEN WHITMORE (LICENSING & CREDENTIALING MANAGER) |
| Mailing Address: | 6662 Highway 75 Ste. 114 Pinson |
| State: | AL US |
| Postal Code: | 351263254 |
| Phone Number: | 2056930100 |
| Fax Number: | 2056930101 |
| NPI Enumeration Date: | 10/26/2010 |
| NPI Last Update Date: | 02/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |