FLORALA FAMILY DENTAL CARE NPI 1336635895

Clinic/Center (Dental) in Florala, AL

NPI 1336635895 Organization Clinic/Center Dental

About FLORALA FAMILY DENTAL CARE

Florala Family Dental Care is a provider established in Florala, Alabama specializing in clinic/center (dental) . The NPI number of Florala Family Dental Care is 1336635895 and was assigned on July 2018. The practitioner's primary taxonomy code is 261QD0000X with license number 6491C (AL). The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Dr. John W Frerich Dds (Owner/dentist)

NPI

1336635895

Provider NameFLORALA FAMILY DENTAL CARE
Provider Location Address24244 5TH AVE FLORALA, AL 36442
Provider Mailing Address24244 5TH AVE FLORALA, AL 36442
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date07-09-2018
Last Update Date07-09-2018


Primary Taxonomy

Taxonomy Code261QD0000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationDental
License No.6491C
License StateAL

Business Address

FLORALA FAMILY DENTAL CARE
24244 5TH AVE
FLORALA, AL
ZIP 36442
Phone: (334) 219-5831
Fax: (334) 647-6475

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Mailing Address

FLORALA FAMILY DENTAL CARE
24244 5TH AVE
FLORALA, AL
ZIP 36442
Phone: (334) 219-5831
Fax: (334) 647-6475



Authorized Official

Authorized Official NameDR. JOHN W FRERICH DDS
Authorized Official TitleOWNER/DENTIST
Authorized Official Phone(334) 219-5831

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1316965718DR. WILLIAM EDWARD HOLLEY DMD
Individual
Dentist (General Practice)24244 5TH AVE
FLORALA, AL 36442
(334) 858-6816

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.