Contract Details
EZ Comp Care, Inc.
Facility name
EZ Dental Care
Provider ID
P000009166
NPI
1891157376
Tax ID
811842202
Effective Date
5/24/2018
Last Updated
3/28/2019
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_384
Location Details
Address
5740 Carmichael Rd
Montgomery, AL 36117
United States
County
Montgomery
Phone
8559392667 (Phone)
Billing Details
Address
PO Box 6787
Brandon, FL 335086013
Billing Phone
8559392667
Specialty Type
Dentistry
Map
Address