Provider Demographics
NPI:1548040538
Name:CENTRAL ALABAMA DENTAL, PLLC
Entity type:Organization
Organization Name:CENTRAL ALABAMA DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCALANA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:334-259-5317
Mailing Address - Street 1:10445 NW 50TH PL
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-1737
Mailing Address - Country:US
Mailing Address - Phone:954-675-3088
Mailing Address - Fax:
Practice Address - Street 1:2481 PINNACLE WAY
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-6543
Practice Address - Country:US
Practice Address - Phone:334-259-5317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty