Provider Demographics
NPI:1942710017
Name:CORNERSTONE DENTAL SERVICES, PC
Entity type:Organization
Organization Name:CORNERSTONE DENTAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:VICKERY
Authorized Official - Last Name:BARGANIER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-870-9600
Mailing Address - Street 1:3055 LORNA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4513
Mailing Address - Country:US
Mailing Address - Phone:205-870-9600
Mailing Address - Fax:
Practice Address - Street 1:3055 LORNA RD STE 100
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-4513
Practice Address - Country:US
Practice Address - Phone:205-870-9600
Practice Address - Fax:205-994-6042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental