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General NPI Number Information
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NPI Number | 1174949549
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Entity Type | Organization
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Legal Business Name | R HENRY ESHAM II DMD, PC
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 703 BISHOP LN N
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City | MOBILE
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State | AL
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Zip | 36608-5838
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Country | US
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Telephone | 251-343-0501
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Fax |
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Provider Business Mailing Address
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Address Line | 703 BISHOP LN N
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City | MOBILE
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State | AL
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Zip | 36608-5838
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Country | US
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Telephone | 251-343-0501
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD HENRY ESHAM II
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Credential | DMD
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Telephone | 251-343-0501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6036
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License Number State | AL
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