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General NPI Number Information
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NPI Number | 1659486397
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Entity Type | Organization
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Legal Business Name | RICHARD H REAL. JR., D.M.D., P.A.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 2161 CLEARBROOK ROAD
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City | HOOVER
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State | AL
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Zip | 35226
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Country | US
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Telephone | 205-823-2577
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Fax | 205-823-2585
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Provider Business Mailing Address
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Address Line | 2161 CLEARBROOK ROAD
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City | HOOVER
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State | AL
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Zip | 35226
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Country | US
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Telephone | 205-823-2577
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Fax | 205-823-2585
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD H REAL
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Credential | DMD
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Telephone | 208-823-2577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2931CS
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License Number State | AL
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