Shelton Park Mims D.M.D.

NPI 1124237805 - Dentist - 1223E0200X

NPI Details
NPI 1124237805
Gender Male
Enumeration Date 05/21/2007
Last Updated 05/21/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
4101 BALMORAL DR SW
SUITE B
HUNTSVILLE AL, 35801-6409, US
Phone (256) 880-6556
Fax (256) 880-2945
Business Location
4101 BALMORAL DR SW
SUITE B
HUNTSVILLE AL, 35801-6409, US
Phone (256) 880-6556
Fax (256) 880-2945
Toxanomy
Taxonomy Code 1223E0200X
License State Alabama
License Number 3879
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According to our database, Dr. Shelton Park Mims D.M.D. NPI is 1124237805, taxonomy code is 1223E0200X and license number is 3879, license state is located at Alabama. Shelton Park Mims D.M.D. physically located at 4101 Balmoral Dr Sw, Huntsville AL, 35801-6409. NPI Number Shelton Park Mims D.M.D. has the Individual type.

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1124237805 NPI number is provided on an as is basis without warranty of any kind. 1124237805 is maintained by the National Plan & Provider Enumeration System. The contents of Shelton Park Mims D.M.D. are for informational purposes only.