Individual
TIMOTHY BLAKE MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
211 N MAIN STREET, WARRIOR, AL 35180
(205) 647-3181
(205) 647-1134
Mailing address
211 N MAIN STREET, WARRIOR, AL 35180
(205) 647-3181
(205) 647-1134
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4944
AL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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