# ORAL AND MAXILLOFACIAL SURGERY OF EAST AL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417064270
- **Authorized official:** DR. JAMES GRADY DDS (PRESIDENT)
- **Authorized official phone:** (334) 749-3436

## Contact information

- **Practice address:** 121 N 20TH ST STE 20B, OPELIKA, AL 36801-5456
- **Practice address phone:** (334) 749-3436
- **Practice address fax:** (334) 749-3223
- **Mailing address:** 121 N 20TH ST STE 20B, OPELIKA, AL 36801-5456
- **Mailing address phone:** (334) 749-3436
- **Mailing address fax:** (334) 749-3223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2956CS | AL | Yes |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 10/07/2016