| S.m. Mahan L.l.c | |
|
19330 Highway 139 Brierfield AL 35035-3658 | |
| (205) 665-2723 | |
| (205) 665-1037 |
| Full Name | S.m. Mahan L.l.c |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 19330 Highway 139, Brierfield, Alabama |
| Authorized Official Name and Position | Stanley Michael Mahan (DENTIST/OWNER) |
| Authorized Official Contact | 2056652723 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S.m. Mahan L.l.c Po Box 100 Brierfield AL 35035-0100 Ph: (205) 665-2723 | S.m. Mahan L.l.c 19330 Highway 139 Brierfield AL 35035-3658 Ph: (205) 665-2723 |
| NPI Number | 1336314160 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 04/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336314160 | NPI | - | NPPES |
| 529919020 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2722 (Alabama) | Primary |
Genesis Dental Group Brierfield Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 19330 Highway 139, Brierfield, AL 35035 Phone: 205-665-2723 Fax: 205-665-1037 |