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General NPI Number Information
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NPI Number | 1942862131
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Entity Type | Organization
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Legal Business Name | MICHAEL R. PRICE JR. DMD LLC
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 108 NORTH ST E
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City | TALLADEGA
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State | AL
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Zip | 35160-2108
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Country | US
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Telephone | 205-362-2182
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Fax |
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Provider Business Mailing Address
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Address Line | 1334 28TH ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1842
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Country | US
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Telephone | 205-362-1613
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MICHAEL RAY PRICE JR.
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Credential | DMD
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Telephone | 205-362-1613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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