Provider Demographics
NPI:1992153167
Name:GUNNELS, SEAN CLAUDE (DMD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:CLAUDE
Last Name:GUNNELS
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 1:4213 DOLLY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5703
Mailing Address - Country:US
Mailing Address - Phone:205-490-6850
Mailing Address - Fax:205-449-0292
Practice Address - Street 1:4213 DOLLY RIDGE RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5703
Practice Address - Country:US
Practice Address - Phone:205-490-6850
Practice Address - Fax:205-449-0292
Is Sole Proprietor?:No
Enumeration Date:2016-05-28
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34401223P0221X, 1223P0221X
ALD.00067301223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry