Healthcare Provider Details

I. General information

NPI: 1568579811
Provider Name (Legal Business Name): EARL SYLVESTER MCLAUGHLIN JR. DMD MSO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 DAUPHLIN ST
MOBILE AL
36606
US

IV. Provider business mailing address

3151 DAUPHLIN ST
MOBILE AL
36606
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-3373
  • Fax: 241-471-3383
Mailing address:
  • Phone: 251-471-3373
  • Fax: 241-471-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberAL2721
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: