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General NPI Number Information
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NPI Number | 1033764394
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Entity Type | Organization
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Legal Business Name | JAMES P. HANNAHAN, D.M.D., P.C.
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 2200 GATEWAY DR STE AA
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City | OPELIKA
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State | AL
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Zip | 36801-6884
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Country | US
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Telephone | 877-481-7804
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Fax | 334-297-3913
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Provider Business Mailing Address
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Address Line | 2200 GATEWAY DR STE AA
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City | OPELIKA
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State | AL
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Zip | 36801-6884
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Country | US
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Telephone | 877-481-7804
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Fax | 334-297-3913
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Authorized Official
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Title or Position | OWNER
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Name | JAMES HANNAHAN
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Credential | D.M.D.
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Telephone | 877-481-7804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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