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Individual

SHAWN Y BURL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
139 3RD AVE W, BIRMINGHAM, AL 35204-4114
(205) 254-8555
(205) 254-8744
Mailing address
139 3RD AVE W, BIRMINGHAM, AL 35204-4114
(205) 254-8555
(205) 254-8744

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4077
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
043851580
TAX ID
AL
01
195624
UNITED CONCORDIA
AL
01
51517010
BLUE CROSS BLUE SHIELD
AL
01
631263166
TAX ID
AL
Enumeration date
04/20/2007
Last updated
05/28/2019
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