NPI 1134421746

Vital Smiles Alabama PC

Organisation Health Maintenance Organization Mobile, AL

Practice location

Address: 2727 Pleasant Valley Rd, Mobile, AL 36606-2162
Phone: (251) 473-5705
Mailing address: 1900 Crestwood Blvd Suite 211, Irondale, AL 35210-2034

Authorised official

Name: George David Johnson
Title: President
Phone: (205) 271-6851

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 4794 (AL)

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Registry record

NPI: 1134421746
Entity type: Organization
NPI issued: 2 Dec 2010
Record last updated: 2 Dec 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.