Healthcare Provider Details

I. General information

NPI: 1194748145
Provider Name (Legal Business Name): JAMES EMMETT GUNNELLS, DMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 5TH ST NE
ALICEVILLE AL
35442-2200
US

IV. Provider business mailing address

106 5TH ST NE
ALICEVILLE AL
35442-2200
US

V. Phone/Fax

Practice location:
  • Phone: 205-373-8726
  • Fax:
Mailing address:
  • Phone: 205-373-8726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3040
License Number StateAL

VIII. Authorized Official

Name: JAMES EMMETT GUNNELLS
Title or Position: PRESIDENT
Credential: DMD
Phone: 205-373-8726