Provider Demographics
NPI:1134598246
Name:COVE FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:COVE FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:DULING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-534-1475
Mailing Address - Street 1:6707 HIGHWAY 431 S STE 103
Mailing Address - Street 2:
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-9299
Mailing Address - Country:US
Mailing Address - Phone:256-534-1475
Mailing Address - Fax:256-533-1425
Practice Address - Street 1:6707 HIGHWAY 431 S STE 103
Practice Address - Street 2:
Practice Address - City:OWENS CROSS ROADS
Practice Address - State:AL
Practice Address - Zip Code:35763-9299
Practice Address - Country:US
Practice Address - Phone:256-534-1475
Practice Address - Fax:256-533-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
AL6157261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment