Organization
S.M. MAHAN L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY MICHAEL MAHAN JR. D.M.D (DENTIST/OWNER)
(205) 665-2723
Entity
Organization
Contact information
Practice address
19330 HIGHWAY 139, BRIERFIELD, AL 35035-3658
(205) 665-2723
(205) 665-1037
Mailing address
PO BOX 100, BRIERFIELD, AL 35035-0100
(205) 665-2723
(205) 665-1037
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2722
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529919020
—
AL
Enumeration date
04/23/2008
Last updated
04/25/2012
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