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Individual

DR. CHARLES MAX MERRILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2424 DANVILLE ROAD SUITE O, DECATUR, AL 35603
(256) 351-7707
(256) 351-7729
Mailing address
P.O. BOX 1287, HARTSELLE, AL 35640
(256) 773-1407

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2573
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
836007
UNITED CONCORDIA
AL
01
94685
BLUE CROSS & BLUE SHIELD
AL
Enumeration date
10/17/2006
Last updated
07/08/2007
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