Provider Demographics
NPI:1336382845
Name:DURHAM, JAMES RUSSELL (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RUSSELL
Last Name:DURHAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7559C HIGHWAY 72 WEST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8812
Mailing Address - Country:US
Mailing Address - Phone:256-325-0078
Mailing Address - Fax:256-325-0079
Practice Address - Street 1:7559C HIGHWAY 72 WEST
Practice Address - Street 2:SUITE 105
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8812
Practice Address - Country:US
Practice Address - Phone:256-325-0078
Practice Address - Fax:256-325-0079
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL55211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics