Healthcare Provider Details

I. General information

NPI: 1164460689
Provider Name (Legal Business Name): DON M RASBURY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E 10TH ST STE 106
ANNISTON AL
36207-5771
US

IV. Provider business mailing address

230 E 10TH ST STE 106
ANNISTON AL
36207-5771
US

V. Phone/Fax

Practice location:
  • Phone: 256-741-7340
  • Fax: 256-741-1234
Mailing address:
  • Phone: 256-741-7340
  • Fax: 256-741-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number3621
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: