Provider Demographics
NPI:1699894162
Name:ALABAMA FAMILY DENTAL
Entity type:Organization
Organization Name:ALABAMA FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:251-344-5461
Mailing Address - Street 1:5414 OLD SHELL RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-2850
Mailing Address - Country:US
Mailing Address - Phone:251-344-5461
Mailing Address - Fax:251-344-6032
Practice Address - Street 1:5414 OLD SHELL RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-2850
Practice Address - Country:US
Practice Address - Phone:251-344-5461
Practice Address - Fax:251-344-6032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty