Provider Demographics
NPI:1336576107
Name:CALERA DENTAL CENTER
Entity type:Organization
Organization Name:CALERA DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-620-3312
Mailing Address - Street 1:101 HIGHWAY 87 BLDG 200
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-7209
Mailing Address - Country:US
Mailing Address - Phone:205-620-3312
Mailing Address - Fax:205-620-9959
Practice Address - Street 1:101 HIGHWAY 87 BLDG 200
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040-7209
Practice Address - Country:US
Practice Address - Phone:205-620-3312
Practice Address - Fax:205-620-9959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL46961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty