Provider Demographics
NPI:1578843090
Name:PREMIER FAMILY DENTISTRY
Entity type:Organization
Organization Name:PREMIER FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZANATHOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-621-5304
Mailing Address - Street 1:9200 HIGHWAY 119
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-5337
Mailing Address - Country:US
Mailing Address - Phone:205-621-5304
Mailing Address - Fax:205-621-5306
Practice Address - Street 1:9200 HIGHWAY 119
Practice Address - Street 2:SUITE 200
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-5337
Practice Address - Country:US
Practice Address - Phone:205-621-5304
Practice Address - Fax:205-621-5306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5657261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental