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General NPI Number Information
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NPI Number | 1962557199
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Entity Type | Individual
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Provider Name | MICHAEL STANLEY FIRTH D.D.S
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 4500 MONTEVALLO RD SUITE B105
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City | IRONDALE
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State | AL
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Zip | 35210-3129
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Country | US
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Telephone | 205-595-2273
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Fax | 205-595-2235
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Provider Business Mailing Address
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Address Line | 4500 MONTEVALLO RD B105
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City | IRONDALE
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State | AL
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Zip | 35210-3129
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Country | US
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Telephone | 205-595-2273
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Fax | 205-595-2235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 10779
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License Number State | GA
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