Provider Demographics
NPI:1053009282
Name:VILLAGE DENTAL CARE LLC
Entity type:Organization
Organization Name:VILLAGE DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:334-821-5291
Mailing Address - Street 1:761 N DEAN RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4027
Mailing Address - Country:US
Mailing Address - Phone:334-821-5291
Mailing Address - Fax:334-821-5292
Practice Address - Street 1:761 N DEAN RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4027
Practice Address - Country:US
Practice Address - Phone:334-821-5291
Practice Address - Fax:334-821-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty