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
121 N 20th St Suite 20 - C
Opelika, AL 36801
United States
County
Lee
Phone
8559392667 (Phone)
Billing Details
Address
PO Box 6787
Brandon, FL 335086013
Billing Phone
8559392667
Specialty Type
Dentistry
Map
Address