1992981443 NPI number — TODAY'S FAMILY DENTISTRY, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992981443 NPI number — TODAY'S FAMILY DENTISTRY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TODAY'S FAMILY DENTISTRY, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992981443
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 910
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULLMAN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35056-0910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-739-3337
Provider Business Mailing Address Fax Number:
256-739-3165

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
506 1ST AVE SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CULLMAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35055-4301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-739-3337
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KIM
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
YONGTAE
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
256-739-3337

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  4937 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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