Healthcare Provider Details

I. General information

NPI: 1952021370
Provider Name (Legal Business Name): VANESSA STONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 19TH ST S
BIRMINGHAM AL
35233-1927
US

IV. Provider business mailing address

1990 COUNTY ROAD 411
CLANTON AL
35045-8086
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-8101
  • Fax:
Mailing address:
  • Phone: 205-258-6484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: