Healthcare Provider Details

I. General information

NPI: 1821004805
Provider Name (Legal Business Name): MICHAEL F MCCARTHY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 LORNA RD SUITE 248
HOOVER AL
35244-3005
US

IV. Provider business mailing address

617 LAKE CREST DR
HOOVER AL
35226-5036
US

V. Phone/Fax

Practice location:
  • Phone: 205-733-2022
  • Fax: 205-733-9678
Mailing address:
  • Phone: 205-987-9318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3871
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: