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General NPI Number Information
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NPI Number | 1538294921
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Entity Type | Organization
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Legal Business Name | C.D. HARRELL III DMD
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 71A N. SECTION ST.
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City | FAIRHOPE
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State | AL
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Zip | 36532
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Country | US
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Telephone | 251-928-8221
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Fax | 251-928-8229
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Provider Business Mailing Address
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Address Line | 71-A NORTH SECTION ST.
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City | FAIRHOPE
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State | AL
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Zip | 36532
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Country | US
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Telephone | 251-928-8221
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Fax | 251-928-8229
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CLAUDE DOUGLAS HARRELL III
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Credential | D.M.D
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Telephone | 251-928-8221
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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 | 4512
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License Number State | AL
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