Organization
M SHANE STEVENSON DMD, MD ORAL AND MAXILLOFACIAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL SHANE STEVENSON DMD, MD (PRESIDENT)
(256) 355-1242
Entity
Organization
Contact information
Practice address
1401 STRATFORD RD SE, DECATUR, AL 35601-6022
(256) 355-1242
(256) 355-1259
Mailing address
1401 STRATFORD RD SE, DECATUR, AL 35601-6022
(256) 355-1242
(256) 355-1259
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5063
AL
Other
Enumeration date
10/12/2006
Last updated
10/30/2008
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