Provider Demographics
NPI:1215146725
Name:CHASE FAMILY DENTISTRY, P.C.
Entity type:Organization
Organization Name:CHASE FAMILY DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDALEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-852-9110
Mailing Address - Street 1:1392 JORDAN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-8240
Mailing Address - Country:US
Mailing Address - Phone:256-852-9110
Mailing Address - Fax:256-852-3443
Practice Address - Street 1:1392 JORDAN RD
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-8240
Practice Address - Country:US
Practice Address - Phone:256-852-9110
Practice Address - Fax:256-852-3443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5281122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty