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MALEA JANE GROSS D.M.D

>> Dentist >> Dental Providers

Registrant NPI Number: 1255545240

Individual Registrant:
 MALEA JANE GROSS D.M.D
Gender: F
Sole Proprietor

Location and contact information for practice:
6496 HWY 269 SUITE 201  PARRISH, AL 35580 US
Tel: 205-686-2799  Fax: 205-686-0000

Contact information for business:
P.O. BOX 267  PARRISH, AL 35580 US
Tel: 205-686-2799  Fax: 205-686-0000

Registration Information:
NPI: 1255545240
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
AL4924

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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