McCullough And Stevens
Dentist, General Practice in Trussville, AL. Organization (NPI-2).
NPI number1104064559
StatusActive
Last updated in NPPESJan 22, 2009
Details
- NPI
- 1104064559
- Entity type
- Organization (NPI-2)
- Legal business name
- McCullough And Stevens
- Organization subpart
- No
- Enumeration date
- Jan 22, 2009
- Last updated
- Jan 22, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 5210 | AL | Yes |
Practice location
4643 Camp Coleman Rd Ste 125Trussville, AL 35173-2838
Phone 205-218-9823
Mailing address
4643 Camp Coleman Rd Ste 125Trussville, AL 35173-2838
Phone 205-218-9823
Authorized official
Christian Adama Stevens
Partner Dentist
2052189823
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