Individual
DR. TALMADGE WADE LIVEOAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2227 DRAKE AVE SW, SUITE 10A, HUNTSVILLE, AL 35805
(256) 882-2227
(256) 882-2252
Mailing address
2227 DRAKE AVE SW, SUITE 10A, HUNTSVILLE, AL 35805
(256) 882-2227
(256) 882-2252
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3521
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51094172
BLUE CROSS PROVIDER NUMBE
AL
01
—
872873
UNITED CONCORDIA PROVIDER
AL
Enumeration date
02/05/2007
Last updated
07/08/2007
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