M Shane Stevenson Dmd, MD Oral And Maxillofacial Surgery, PC
Dentist, Oral and Maxillofacial Surgery in Decatur, AL. Organization (NPI-2).
NPI number1700975554
StatusActive
Last updated in NPPESOct 30, 2008
Details
- NPI
- 1700975554
- Entity type
- Organization (NPI-2)
- Legal business name
- M Shane Stevenson Dmd, MD Oral And Maxillofacial Surgery, PC
- Organization subpart
- No
- Enumeration date
- Oct 12, 2006
- Last updated
- Oct 30, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 5063 | AL | Yes |
Practice location
1401 Stratford Rd SeDecatur, AL 35601-6022
Phone 256-355-1242 · Fax 256-355-1259
Mailing address
1401 Stratford Rd SeDecatur, AL 35601-6022
Phone 256-355-1242 · Fax 256-355-1259
Authorized official
Michael Shane Stevenson
President
2563551242
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