Provider Demographics
NPI:1639051279
Name:ANNISTON DENTAL GROUP PLLC
Entity type:Organization
Organization Name:ANNISTON DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMRICK
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:MCELROY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:404-863-7219
Mailing Address - Street 1:1613 LEIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-3830
Mailing Address - Country:US
Mailing Address - Phone:256-236-6021
Mailing Address - Fax:
Practice Address - Street 1:1613 LEIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-3830
Practice Address - Country:US
Practice Address - Phone:256-236-6021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty