Healthcare Provider Details

I. General information

NPI: 1528319951
Provider Name (Legal Business Name): LEWIS P CHAPMAN DMD WILL H CHAPMAN DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 E TRINITY BLVD
MONTGOMERY AL
36106-2806
US

IV. Provider business mailing address

1550 E TRINITY BLVD
MONTGOMERY AL
36106-2806
US

V. Phone/Fax

Practice location:
  • Phone: 334-272-9447
  • Fax: 334-277-9518
Mailing address:
  • Phone: 334-272-9447
  • Fax: 334-277-9518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2950
License Number StateAL

VIII. Authorized Official

Name: LEWIS P CHAPMAN JR.
Title or Position: PRESIDENT
Credential:
Phone: 334-272-9447