LD-NORTHPORT, LLC

TUSCALOOSA, AL
NPI1114634730
Former Legal Business NameJACK SMALLEY, JR., D.M.D., P.C.
Former Legal Business NameNORTH RIVER DENTAL ASSOCIATES, P.C.
Doing Business AsNORTH RIVER DENTAL
Entity TypeOrganization
Authorized ContactLAUREN S DAIGNEAULT
Admin Director
256-783-9468
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2022-11-02
Last Update Date2023-07-03
Business Address
LD-NORTHPORT, LLC
1100 FAIRFAX PARK
TUSCALOOSA, AL 35406-2809
Phone number: 205-752-3506
Mailing Address
LD-NORTHPORT, LLC
1100 FAIRFAX PARK
TUSCALOOSA, AL 35406-2809
Phone number: 205-752-3506