MEDICARE: MICHAEL S. ANGLIN, DDS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4486	AL

General Provider Information

NPI Number	:	1356882385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL S. ANGLIN, DDS, PC

Provider Business Mailing Address
First Line	:	3825 LORNA RD STE 206
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-3003
Country	:	US
Telephone Number	:	205-988-9800
Fax Number	:	205-403-9229

Provider Business Practice Location Address
First Line	:	3825 LORNA RD STE 206
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-3003
Country	:	US
Telephone Number	:	205-988-9800
Fax Number	:	205-403-9229

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL SCOTT ANGLIN
Credential	:	DDS
Telephone Number	:	205-988-9800

Provider Enumeration Date	:	03/09/2017
Last Update Date	:	03/09/2017

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