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Individual

CHARLES STEVEN DAUGHTRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D. M. D.

Contact information

Practice address
4515 SOUTHLAKE PKWY, STE 101, BIRMINGHAM, AL 35244-3317
(205) 988-5656
Mailing address
2525 SADDLECREEK TRL, BIRMINGHAM, AL 35242-6005
(205) 980-8458

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LN03407
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
045814
UNITED CONCORDIA
AL
01
91579
BLUE CROSS BLUE SHILED
AL
Enumeration date
08/03/2006
Last updated
07/08/2007
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