Healthcare Provider Details

I. General information

NPI: 1588682314
Provider Name (Legal Business Name): MICHAEL J MEON DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 VALLEYDALE RD
BIRMINGHAM AL
35244-2007
US

IV. Provider business mailing address

2041 VALLEYDALE RD
BIRMINGHAM AL
35244-2007
US

V. Phone/Fax

Practice location:
  • Phone: 205-988-4470
  • Fax: 205-988-4462
Mailing address:
  • Phone: 205-988-4470
  • Fax: 205-988-4462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number3056
License Number StateAL

VIII. Authorized Official

Name: DR. MICHAEL JOHN MEON
Title or Position: PRESIDENT
Credential:
Phone: 205-988-4470