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Organization
DECATUR MAXILLOFACIAL & COSMETIC SURGERY CENTER
Active
Organization
DECATUR MAXILLOFACIAL & COSMETIC SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM F LITTLEJOHN JR. DMD, MD (PRESIDENT)
(256) 355-8224
Entity
Organization
Contact information
Practice address
2023 DANVILLE PARK DR SW, DECATUR, AL 35603-1833
(256) 355-8224
(256) 355-8819
Mailing address
2023 DANVILLE PARK DR SW, DECATUR, AL 35603-1833
(256) 355-8224
(256) 355-8819
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000026618
MEDICARE PROVIDER NUMBER
AL
05
—
529700210
—
AL
Enumeration date
03/19/2008
Last updated
03/19/2008
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