Provider Demographics
NPI:1962557199
Name:FIRTH, MICHAEL STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STANLEY
Last Name:FIRTH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4500 MONTEVALLO RD
Mailing Address - Street 2:B105
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-3129
Mailing Address - Country:US
Mailing Address - Phone:205-595-2273
Mailing Address - Fax:205-595-2235
Practice Address - Street 1:4500 MONTEVALLO RD
Practice Address - Street 2:SUITE B105
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-3129
Practice Address - Country:US
Practice Address - Phone:205-595-2273
Practice Address - Fax:205-595-2235
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA107791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice