Provider Demographics
NPI:1194748145
Name:JAMES EMMETT GUNNELLS, DMD, PC
Entity type:Organization
Organization Name:JAMES EMMETT GUNNELLS, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EMMETT
Authorized Official - Last Name:GUNNELLS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-373-8726
Mailing Address - Street 1:106 5TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ALICEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35442-2200
Mailing Address - Country:US
Mailing Address - Phone:205-373-8726
Mailing Address - Fax:
Practice Address - Street 1:106 5TH ST NE
Practice Address - Street 2:
Practice Address - City:ALICEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35442-2200
Practice Address - Country:US
Practice Address - Phone:205-373-8726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51092854OtherBCBS
AL831721OtherUNITED CONCORDIA