Organization
STAFFORD DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRA MONTGOMERY STAFFORD DMD (OWNER)
(205) 221-6700
Entity
Organization
Contact information
Practice address
300 N AIRPORT RD, STE 1, JASPER, AL 35504-2517
(205) 221-6700
(205) 221-9194
Mailing address
300 N AIRPORT RD, STE 1, JASPER, AL 35504-2517
(205) 221-6700
(205) 221-9194
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3788
AL
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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