Advanced Aesthetics Dental Center And Spa

NPI 1154634954 - Dentist - 122300000X

NPI Details
NPI 1154634954
Enumeration Date 07/21/2010
Last Updated 07/21/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name TRACIE M TRACIE
Position PRESIDENT
Phone (251) 967-1144
Fax
Practice Location
350 CYPRESS BEND BLVD STE 102
GULF SHORES AL, 36542-2773, US
Phone (251) 967-1144
Fax
Business Location
PO BOX 852073
MOBILE AL, 36685-2073, US
Phone (251) 967-1179
Fax
Toxanomy
Taxonomy Code 122300000X
License State Alabama
License Number 5312
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According to our database, Advanced Aesthetics Dental Center And Spa NPI is 1154634954, taxonomy code is 122300000X and license number is 5312, license state is located at Alabama. Advanced Aesthetics Dental Center And Spa physically located at 350 Cypress Bend Blvd Ste 102, Gulf Shores AL, 36542-2773. NPI Number 1033115704 has the healthcare provider type.

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1154634954 NPI number is provided on an as is basis without warranty of any kind. 1154634954 is maintained by the National Plan & Provider Enumeration System. The contents of Advanced Aesthetics Dental Center And Spa are for informational purposes only.